Eliminating manual processes to improve the client experience
As a third-party administrator of health plans, Employee Benefit Management Services (EBMS) is on a mission to improve the care experience, reduce health costs, and simplify the benefit journey for everyone.
The company administers health insurance for 300 employers, and serving its clients means EBMS needs to share important insurance data with different organizations — from healthcare providers and pharmacies to employers and insurance members.
Prior to MuleSoft, EBMS had to manually create all up to 80,000 files per day to send to clients. Each client they served used 10-20 different partners to support their health plan and employee benefits. Manually creating each of these was a cumbersome, time-consuming, and error-prone process that led to a disconnected client experience and a frustrating healthcare experience for the patients.
Delivering a single patient view to EBMS and its clients using API integrations
To improve the client experience and increase operational efficiency, EBMS needed to adopt a new strategy and unified platform that enables them to quickly and efficiently share insurance data with multiple organizations in real-time.
With MuleSoft’s Anypoint Platform™, EBMS took an API-led integration approach — using APIs and web services to build an electronic data interchange (EDI) solution that connects to different organizations’ systems and creates a single view of all data. With MuleSoft, EBMS can now securely send data to health providers, pharmacies, employers, and insurers in real-time via a web portal and mobile app.
EBMS then reused the same API integrations to build a push notification feature that sends stakeholders critical updates and information via text or email. This saves employers and insurance members critical time because they only need to log in to the portal or mobile app only when they receive an important push notification.
“With MuleSoft, we didn’t need to completely overhaul the systems and data we have; instead, we built APIs that helped us better leverage existing data — fast. Thanks to this API-led approach, we now deliver the great experience that our clients deserve.”
Onboarding clients in 2 days and reducing operational costs by 40%
EBMS now also has a real-time view of critical moments that happen in the insurance member journey — including submitting a claim, changing the status of a claim, and more.
Thanks to the new data interchange solution that EBMS built, customer service calls are down by 50% — a sign that employers, insurance members, and other stakeholders can easily find the information they need via the web portal or mobile app.
EBMS also witnessed a 40% reduction in operational cost as teams more easily reused MuleSoft assets to create the custom client-driven partner interfaces. Additionally, EBMS can now easily connect to new systems that their clients or employers have; this means new employers can be onboarded in just two days instead of 15 days.