Challenge

American Enterprise Group, Inc. (AEG) based in Des Moines, Iowa, employs approximately 450 people serving over 675,000 policy holders in the health and life space and has more than $625M in annualized premiums. With a focus on the Medicare supplemental line of business across 49 states plus the District of Columbia, AEG provides Medicare supplement, dental and other claim payments to a wide range of providers including hospitals, doctors, physical therapists, and labs. As part of transformation efforts to bring technology to the forefront and maximize the customer experience, AEG recognized that they needed to refine their payment distribution process.

As part of transformation efforts to bring technology to the forefront and maximize the customer experience, AEG recognized that they needed to refine their payment distribution process. They required a partner who not only understood their complex business, but who could streamline their claim payment process while also providing financial enhancements to improve their bottom line. AEG has taken aim at maintaining a very high-level of auto-adjudication (over 99%) and wanted a partner that would not only maintain that level, but bring added benefits to support the customer experience. 

“This was a move we needed to make, but it was daunting,” says Jon Paulsen, Lead Business Analyst. “We had to do a thorough analysis of our current situation and what was available in order to justify the switch.”

Among the key criteria was a seamless, effortless transition. Additionally, the company didn’t want to lose any of the capabilities it had with its previous vendor – but needed someone who could better respond to day-to-day management and payment needs.

After a thorough search, AEG made the decision to move its claims payment processing to Optum Financial in January of 2017. The difference was apparent instantly.

“Optum Financial makes it easier to manage our internal system and processes with the solutions they offer. Optum Financial has been a great partner who has provided outstanding value and customer service.”

Bethany Cross   –  Director of Claims, American Enterprise Group, Inc.

Solution

Medicare supplement insurance brings a unique set of challenges around payments. Regulations are ever-changing and must be strictly adhered to. Medicare also makes frequent adjustments to reimbursements, necessitating additional work to distribute small amounts of funds. The cost for these small checks can add up quickly. Because of these complexities and costs, AEG was eager to find a solution that helped increase e-payment adoption. Optum Financial’s payment solution provides AEG with a flexible and efficient process that helps increase speed of payment while lowering check costs.

“Optum Financial’s payment solution has helped us realize more business benefits than we originally thought. I always have the information needed to monitor results,” says Bethany Cross, Director of Claims.

That’s because Optum Financial’s sophisticated payment preferencing system ensures that payees receive the type of payment that they want, which maximizes e-payment adoption. Optum Financial has a preference database of 750,000+ payee preferences that payees get paid the way they want, every time.

During its first year, Vpay has helped AEG achieve a 55% adoption rate for electronic payments. Not only has this resulted in significant savings, but also in a $1.2 million ROI.

Additionally with Optum Financial, AEG is realizing higher levels of customer satisfaction due in part to faster payments through virtual cards, inclusion of remittance data with the payment and payees receiving payments the way they want.

Before they partnered with Optum Financial, AEG didn’t realize how time consuming and burdensome the management of their claim payments had become.

By leveraging the Vpay portal and daily recon files, the financial balancing process that used to take hours now takes less than five minutes daily.

Optum Financial’s payment solution provides AEG with:

• Payment flexibilty
• Reduced print/mail costs
• Seamless payment management and delivery
• Real-time, configurable data access and management
• One call customer resolution

“One thing that impressed us was the fact that providers seemed more agreeable to receiving virtual cards through Optum Financial than they were with other payment processors.”

Jon Paulsen   –  Lead Business Analyst, American Enterprise Group, Inc.