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Highlights: HM Health Solutions

Simplifying online payment for direct-pay members

Direct-pay health plan members are not insured by their employer but purchase their medical insurance directly via the health care marketplace or Medicare. Before direct-pay members even see the doctor, they are several steps into their health care experience. These steps include choosing and managing their own medical coverage and paying their own health insurance premiums.

Health plans rely on HM Health Solutions (HMHS) to make online payment an easy transaction for their direct-pay members. In 2019, 13 health plan customers used HMHS' Enterprise Health Solution Platform, which is the technology that supports health care plan members' administrative experience from enrollment to claims, or end to end.

In October 2019, HMHS completed an upgrade that gave direct-pay members the choice of paying their premiums using a personal computer, tablet, or phone. On any device, the amount due is visible on the very first screen, and users can complete their transaction in just a few clicks. From September to November 2019, the number of payments processed electronically jumped from about 71,100 to about 91,500. And direct-pay members made fewer customer service inquiries about how to pay premiums online.

To further simplify the experience for these members, the upgrade eliminated the need for them to enter an account number when paying. In addition, members receive notifications via text or email about their transaction at every step, such as when an invoice is due and payment has been processed.

"We've seen more members than ever take advantage of the new online payment solution, which has greatly improved their premium payment experience," said Mark Sobieski, vice president, service operations for one of HMHS' health plan customers. "Advancements like this one on the Enterprise Health Solution Platform play an important role in our organization's ability to deliver a more convenient member experience in a highly competitive consumer market."

Mark Sobieski, Tracy Mueller, and Brett Huberman

Mark Sobieski and Tracy Mueller work with HMHS' Brett Huberman (left) to enhance health plan members' online experience.


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