Case Study: Leading Health Plan in Puerto Rico Services More than 117,000 MA Members with Help of the CodySoft® Collateral Management Module®

The Health Plan

The CODY® client featured is a leading health plan in Puerto Rico. As an independent licensee of the BlueCross BlueShield Association, the plan offers Medicare Advantage products and services to more than 117,000 members, as well as Medicaid and commercial products. The plan uses the CodySoft® Collateral Management Module® to manage production of its Annual Notice of Changes (ANOCs) and Evidence of Coverage (EOCs) documents.

The Challenge

Prior to implementing the CodySoft® Collateral Management Module®, the health plan manually created its AEP materials. This manual process was fraught with inefficiencies and document errors.

“One of the main issues we had when we were creating the documents manually was a lack of the standardization of language because we were working in different templates,” said the plan’s Product Development Supervisor. “We had different departments using different wording and descriptions for benefits.”

The plan also struggled with time constraints and meeting key deadlines.

“There’s such a short period of time between when the bids are approved and the documents have to be mailed, and so many details can go wrong.”

Tight timelines and inefficient processes led to compliance issues.

“The year before we implemented CodySoft®, we had noncompliance issues for all eight of our products. Those errata sheets were very expensive to print. CMS can put a restriction on letting you go into the open enrollment period for noncompliance issues, so this was an important issue that we had to correct.”

The Solution

In 2015, the health plan began research to find a solution.

“Our Sales VP found CodySoft® online and knew one of our competitors was working with CODY because they had had similar issues to ours,” said the plan’s Product Development Supervisor.

CodySoft® is a suite of web-based software products designed specifically for health plans and their complex environment. Given the health plan’s challenges, CODY experts recommended CodySoft®’s Collateral Management Module® to streamline creation of the annual enrollment period materials.

CodySoft®’s Collateral Management Module® is the only application of its kind to incorporate project management, document creation, assets management, compliance tracking, reporting, and more – with added features that centralize all areas of the health plan environment, including compliance, IT, creative services and operations.

The Results

The health plan implemented CodySoft® and has since solved many of the challenges it faced when producing the documents manually. Many of the benefits come from CodySoft®’s ability to work with data grids and templates, rather than requiring that products be created or updated individually.

“With CodySoft®, one of the advantages is that once we have the information in just one template and just one person is using and editing it, we’re guaranteed to have standard language across all the products using that template. It also helped with version control, with different departments working on the materials.”

The plan also was able to work more easily and comfortably within the rigid production timeline.

“With CodySoft® we can work ahead, when there’s plenty of time and there’s not such a rush. We can work on the grids and tables before we’ve even gotten information from CMS that year, to get started much sooner.”

Not only did CodySoft® allow the plan to work ahead, but it saved the team time.

“It does help save time, when you can make corrections in just one template instead of in each product. If the correction is tied to five plan documents, you only have to make it once. Also, when we do our bid, we just have to do one final parsing and verify all the information is correct. This helps save time in the final draft submitted to CMS.”

CodySoft® provided the plan with the tools to produce documents with zero erratas for their ANOCs and EOCs in 2017.

“It was a big accomplishment for us. Since we were in a corrective action plan, CMS saw it was a real improvement, so we didn’t have any compliance issues with them.”

The Experience

The three phrases the plan’s Product Development Supervisor used to describe CodySoft® were efficient, reliable, and easy to use.

In January 2017, the health plan hired a new employee who had previously only manually produced AEP materials. The team trained her on CodySoft® and tasked her with developing the Summary of Benefits documents.

“When she did the first parsing, she was shocked to see that she already had all nine products together. She was really thrilled to see results the first time she used it.”

In addition to the CodySoft® program, the health plan enjoys a high level of customer service.

“The service that we get is pretty much immediate. Every time we have a question, we get a quick answer, which is very important to us.”

The plan was so pleased with using CodySoft® for its Medicare Advantage materials that it recently decided to implement the software for its commercial line.

“To be honest, we do believe that CodySoft® is one of, if not the best, option that there is.”