PAIN DESCRIPTION:

Imagine there exists back-office integration between your front office system and all of the following: accounting system, Outlook, underwriting/rating system, claim processing system, and reporting tools. Moreover, your front office allows you to keep track of everything related to your prospects, member companies, subscribers, agencies, brokers, health care providers, and specialists. No more fumbling through multiple interfaces or dealing with multiple logins.

No need to imagine anymore. Now you can experience it.

PAIN ANALYSIS:

In today’s competitive marketplace, successful Health Plans are becoming increasingly customer-centric. To support this effort, MCOs are looking for comprehensive front office back office solutions to automate and enhance customer-centric processes. Integrated front office back office solutions allow access to the same customer information across multiple departments and across diverse applications, enabling a Health Plan to maximize customer service levels.

Customer service, satisfaction, and retention are critical to growing revenues. It is much more cost-effective to keep an existing member than find a new one, so taking care of existing customers and servicing their needs is of utmost importance. That is why front office applications like QIEM HMOZ Customer Relationship Management (CRM) solution, the core of front office software for managed care organizations, are projected to become the largest growth segment in the software market and are expected to have a lasting impact on how Organizations/PPOs conduct business in the future.

An investment in a front office solution will allow an Organizations to build its business around subscribers. This commitment leads to strong customer loyalty and higher sales productivity. QIEM HMOZ offers the following management solutions:

QIEM HMOZ Sales 

This functionality empowers sales teams to maximize both sales efficiency and member loyalty. When integrated with most back office systems, QIEM HMOZ can deliver direct access to pricing, plan design specifications, quotes, and renewals.

QIEM HMOZ Marketing

Organizations can manage sales campaigns end-to-end and use QIEM HMOZ tools for easy-to-use datamining, prospect response tracking, return on investment (ROI) measurement, and campaign metrics reporting.

Sales quotes can be created in QIEM HMOZ and flagged for submission to your underwriting system. Underwriters can work with this information to return their rates. Information can be easily submitted to your accounting system. The accounting application then validates the order and recalculates with current tax information. If the sales quote or renewal meets submission criteria, it sends an approval notification back to QIEM HMOZ.

Benefits

  • Enables integration between QIEM HMOZ and back-office financial management applications
  • Provides timely, accurate financial information critical to selling to and supporting customers
  • Presents sales people and accounting personnel the information they need in a familiar interface they understand
  • Provides the flexibility to accommodate customizations and work in concert with unique business processes

Features

  • Accounting Information
  • Quotes and Renewals History
  • Payments
  • Plans/Products Information
  • Plan Design Information
  • Rating/Pricing
  • Groups/Reports
  • Back-Office Access

Accounting Information

  • View copay, current balance, and aging A/R
  • Access account type and status
  • View last activity, premium YTD and average days to pay

Invoice History

  • View invoice number, date, type, and provider
  • Reference policy number, amounts, tax, and discount

Open Invoices

  • View invoice number, date, due date, and policy number
  • Reference invoice amount, balance, and status

Open Quotes

  • View quote date, number, and type
  • Reference policy number, amount, tax, and deposit data

Payments / Receipts

  • View check date, invoice number, check number, transaction amount, and status
  • Provide rapid responses to customer inquiries

Product Information

  • View product name, plan number, family, group, and type
  • Access pricing, substitute riders, units, and costs

Pricing

  • View current plan/product pricing and discount schedules
  • Produce accurate quotes and associate with customer records

Groups/Reports

  • Create groups based on financial information and status
  • Generate reports, send letters, or create call lists for collections

Create Quotes/Renewals

  • Generate quotes and renewals and associate with customer records
  • Access plan design options, current pricing, and discounts

Back-Office Access

  • Track sales order information from within customer records
  • View credit history and status

With Integration…

  • Sales Wins: Unprecedented levels of insight into the quoting and renewal process
  • Accounting Wins: Increased control of the policy creation process
  • Your Business Wins: Efficiency and effectiveness gains across the organization

Efficiency and Effectiveness Gains Across the Organization

  • Quotes get to accounting faster
  • Customers receive coverage sooner
  • The insurer gets paid faster
  • Sales people and brokers get commission checks earlier
  • Subscribers are serviced better

ADVICE:

It is this high level of QIEM HMOZ integration with leading financial, ERP, claim processing, and underwriting systems that empowers everyone in your managed care organization—from sales, marketing, and underwriting to accounting and finance—to work together, efficiently, in the business of building profitable customer relationships.

Integrating QIEM HMOZ with your back-office solutions gives your employees greater customer insight by enabling them to:

  • Quickly identify cross-sell opportunities and up-sell better riders
  • Easily access payment history information
  • Identify additional purchasing power or lack of it
  • Identify availability of products for sales
  • Quickly assist customers with order status
  • Generate more accurate quotes and proposals

Solution Audit is the best way to find out if your back-office systems integrate with QIEM HMOZ.

One Demo is better than a thousand words, and one Solution Audit is better than a thousand demos. We encourage you to follow our CRM proverb and take advantage of this opportunity.