Case Study: SummaCare - How consumerism is driving SummaCare's digital transformation
SummaCare's Digital Transformation
SummaCare has embarked on a significant digital transformation to improve operations and enhance customer engagement. This transformation centers around integrating various functions under one cohesive team and leveraging technology to improve service delivery.
Key Highlights
Unified Configuration Team
Previously, the finance area managed relationship functions while the configuration area handled edits, resulting in fragmented operations. Now, all activities are consolidated under the configuration team, ensuring a holistic understanding of the product and seamless management of edits. SummaCare's core group of five experts oversees the application, providing precise answers and support.
Enhance Access Across Teams
Beyond the configuration team, the claims team and other departments now have access to the system, enabling them to perform their own investigations and reduce dependencies. This expanded access empowers various teams to independently resolve issues, streamline workflows, and enhance efficiency.
Provider Portal Integration
SummaCare recently integrated edits into the provider portal, allowing providers and members to view edits, submit questions, and file appeals directly through the application. This integration has significantly reduced phone calls and emails to the provider engagement team, streamlining communication and operations.
Listening to Members
SummaCare actively listens to member feedback, rather than making assumptions about their needs. By continually engaging with members through various touch points, SummaCare gains insights into their preferences, driving operational decisions and improvements. Engaging with members through social media platforms allows SummaCare to gather feedback and adapt to their needs. The marketing team has worked diligently to establish a strong digital presence, facilitating better communication and connection with members.
Adapting to Technological Changes
SummaCare acknowledges the rapid pace of technological advancements and is committed to meeting member needs in real-time. They prioritize transparency and coverage, ensuring that member cost-share information is available in accessible formats.
Redefining the Member Experiences
SummaCare's digital transformation is a testament to its commitment to improving member experiences and operational efficiency. By unifying teams, enhancing access, integrating provider portals, actively listening to feedback, and leveraging social media, SummaCare is setting new standards in the healthcare industry. This strategic approach not only enhances service delivery but also positions SummaCare as a forward-thinking and member-centric organization.