Case Study: Friday Health Plans
As the next-generation core administrative system that runs Friday Health Plans’ operation, HealthRules Payer is built for growth, reliability, and customer excellence.
Building for Growth, Efficiency, and a Consumer-First Future
Friday Health Plans, under the leadership of CEO Sal Gentile, has embraced the next-generation core administrative platform for growth, partnering with HealthEdge and UST HealthProof to achieve operational efficiency and exceptional customer service. In response to the Affordable Care Act, which enabled individuals to buy health insurance independently, Friday Health Plans has positioned itself to cater specifically to this market segment.
The Challenge
Faced with the challenge of entering new markets annually and maintaining an efficient operation, Sal Gentile sought a robust IT foundation for Friday Health Plans that mirrored a startup’s ideology. The goal was to prioritize consumer benefits such as free doctor visits, free generic drugs, and catastrophic coverage, tailored for people working independently, without a traditional 9-5 job.
The Solution
HealthEdge’s HealthRules® Payer, a cutting-edge core administrative processing system, provided the solution. Unlike legacy systems plagued by inflexibility and costly manual processes, HealthRules Payer offers scalability, agility, and simplicity in configuration. This platform facilitates rapid adaptation to changing regulations and market demands, enabling Friday Health Plans to expand seamlessly into multiple markets annually.
Results
Implementing HealthRules Payer has yielded remarkable results for Friday Health Plans:
- 99% Member Service First Call Resolution Rate in 2020.
- Improved customer service through the patented, English-like HealthRules Language™, eliminating the need for complex configuration knowledge.
- Enhanced operational scaling capabilities, ensuring growth in existing and new markets without compromising on efficiency or accuracy.
Sal Gentile emphasizes the peace of mind HealthRules Payer brings, stating, "HealthRules Payer does what I need it to do to sleep well at night." With its focus on growth, reliability, and customer excellence, HealthRules Payer is instrumental in achieving Friday Health Plans' ambitious goals.
Conclusion
HealthEdge’s HealthRules® Payer stands out as the core administrative platform for growth, enabling Friday Health Plans to deliver a consumer-first approach efficiently while scaling operations to meet market demands. To learn more about how this platform can transform your business, visit HealthEdge's website.
