Solution Helps Healthcare Insurer Address Government-Mandated Deadline
CRANFORD, N.J.--(BUSINESS WIRE)--
Paragon Solutions, an advisory consulting and systems integration
firm, announced today that it was selected to deliver a Summary of
Benefits and Coverage Solution for a health insurer to help it meet the
government-mandated deadline for fall of 2012.
The health insurer, with over 750-thousand members, engaged Paragon to
provide a concise and comprehensive Summary of Benefits and Coverage in
accordance with federal guidelines to current and potential health plan
participants beginning September 2012. The Summary, according to the
government ruling released earlier this year, must provide members with
the ability to understand and evaluate their health insurance choices.
The Summary must be made available to participants when coverage is
initiated, modified, or as requested.
“The ruling has left a number of health insurers scrambling to determine
how they can address the mandate by the September deadline,” said Tom
Brennan, director of insurance solutions for Paragon. “Many of the firms
we’ve spoken to were looking at stop-gap measures to address the demand
until they realized there was an automated, more productive way to
comply,” Brennan said.
The insurer chose Paragon because of its healthcare industry experience
and expertise with EMC’s customer communications product platform,
xPression. Within weeks, Paragon demonstrated how the insurer could
automate the process of creating, presenting and tracking the summaries
for its members.
“This insurer took a route that will significantly reduce the risk of
non-compliance,” Brennan said. “The penalties for non-compliance can
quickly become costly. The failure penalty is $1,000 per failure -- and
each enrollee can be considered an independent failure,” he said.
About Summary of Benefits and Coverage
The Summary, which can be paper or electronic, must provide members with
the ability to understand their health insurance choices. The template
issued as a guideline requires a number of specific content items that
must be clear, consistent and comparable.
Paragon Solutions is an advisory consulting and systems integration firm
that specializes in enterprise information management to help clients
leverage information assets for better business results. The company
does this through its industry practices, solution accelerators and
specialized technology competencies that help clients achieve
operational efficiency, business scalability and regulatory compliance.
Paragon works with businesses that are focused in a few key industries -
communications, financial services, healthcare, insurance and life
sciences. The industry-focused practices work with Paragon’s competency
groups to address today’s client concerns in Process Optimization,
Information Management and Information Integration.
For more information, please visit the Paragon website at www.consultparagon.com,
or call 1.800.462.5582.
Paragon SolutionsMartha Coacher, email@example.com
Source: Paragon Solutions