How To Choose A Health Insurance App From A Provider

Transcription

1 Vlocity Health Insurance White Paper 3 Key Questions to Ask Your Health Insurance CRM Provider 1

2 Executive Summary The search for a new health plan CRM system can seem like a daunting task. From brand-name companies to software startups, every provider claims to have the best solution for your industry, and they often come to the table with slick demos boasting features that seem to fit your business needs. Most software companies also now call themselves cloud providers, delivering their software via public, multi-tenant cloud platforms or via hosted private clouds. However, not all cloud apps are created equal. So how do you tell which product is right for your business? In this guide, you ll learn the difference between custom cloud development and industry-specific cloud apps. You ll also learn several of the most important questions to ask software providers you are considering partnering with, such as: 1. How long will it take to get the software up and running, and what will be the costs to deploy, maintain, enhance and upgrade the software? 2. What kind of documentation, training and help is available for health-plan specific functions? 3. How well does the provider know the health insurance industry, and how will they ensure their software incorporates the latest best practices and critical business processes as the industry evolves? Introduction to Custom Cloud Development vs. Industry-Specific Cloud Apps This is one of the first distinctions you ll discover when you begin the search for new CRM software. On the one hand, there is custom development, in which a provider (a consulting firm or perhaps your own organization) builds a software system specifically for your business. Regardless of whether it s delivered via the cloud or not, it s still customized - meaning you now are responsible for maintaining these enhancements. On the other hand, there is packaged industry-specific software, or industry apps, in which you start with a package of software that s pre-built based on industry best practices and can be further configured to suit your company s specific needs. It s delivered via the cloud, and the provider is the one responsible for delivering continuous enhancements. These two options are sometimes hard to tell apart, especially since both operate in the cloud, and might even be offered on the same platform (such as Salesforce.com). Yet they are very different and have different long-term implications. Many custom developers offer templates or accelerators that have some industry-specific guidelines already built in. These templates or accelerators are not the same as packaged industry cloud apps. The following questions will help you gain a deeper understanding of the differences between customized industry software and packaged industry-specific apps, as well as between different providers. Armed with the answers to these questions, you ll be able to make the best choice for your business today and for the future. 2

3 Q1 How long will it take to get the software up and running, and what are the costs to deploy, maintain, enhance and upgrade the software? Demos are made to look good. It s their job. Yet most demos from custom developers or systems integrators even ones billed as development accelerators are essentially sample code, so building the real product will take time, even if they re in the cloud. Because demos often take design shortcuts, the final product likely will not include all of the functionality you see in the demo. In contrast, when you see a demo from an industry-specific apps provider, what you re viewing is the real, live product, so all the functionality you see is instantly available. And because it s pre-built, you can skip the development phase and start by adding the finishing touches that are specific or proprietary for your business. When comparing CRM systems, it s also important to understand the process and costs associated with upgrading to a new platform release. With custom development, the provider will likely need to rebuild all the development and reconnect everything within the CRM application, which is timeconsuming and costly. Industry-specific apps typically include regular upgrades and new features as part of the package with no additional customization or integration. When viewing a demo, be sure to ask questions such as: How much time will it take for the production software to be fully up and running? How much of the demo is real, live software that s ready to install today? Are there any workarounds or dummy connectors that could pose challenges in the real version? What is the process for upgrading and enhancing the software in the future? Q2 What kind of documentation, training and help is available for health-plan specific functions? Once your software is up and running, you ll still need help and support along the way. Custom development comes with a standard support package; that is, the help topics only pertain to general functions. For example, it s unlikely that there will be help topics available that explain how to add an eligibility check, map data to your application forms or upload a census. In the case of custom development, the provider must build out additional support, help and training for your specific instance, which takes more time and money. It s also a good idea to ask your provider what kind of training is available to help new users feel comfortable using the software and to drive widespread adoption throughout your company. If you ve chosen to build custom software from templates or accelerators, you are likely on your own when it comes to training and help. You should also find out whether there is a welldeveloped network of users within your industry that can help new users get up to speed and get the most out of their system. Q3 How well does the provider know the health plan industry, and how will they ensure their software incorporates the latest best practices and critical business processes as the industry evolves? While many providers purport to have knowledge of the health insurance industry, some have more than others. Custom developers or integrators often take standard CRM products and customize them based on their previous experience with one or two clients, rather than by applying an in-depth knowledge of the health insurance industry. That s why it s important to ask specific questions to assess a provider s actual industry experience, such as: Have they previously built health plan-specific apps? If so, how many? Do they have the required health plan industry domain skills and expertise? How long have their health plan people been on the team and in the health insurance industry? How many pre-built health plan business processes are already in the software? As well, not all providers are committed to following health insurance industry trends and best practices. Ask your provider how they plan to keep your system up to date with the changes in your industry or business. Will you, as the client, need to suggest changes, or will your provider proactively come to you with new builds? How easy will it be to incorporate these critical changes in the future? 3

4 Vlocity Health Insurance: The Industry App that s Ready for Business In this section, we ll provide our own answers to the questions we posed above so you have a quick reference guide when comparing Vlocity against other providers. 1. Vlocity software is ready for immediate deployment and includes regular upgrades at no extra cost. Vlocity Health Insurance is an industry-specific packaged application that s already built on the Salesforce.com platform. This saves time and money, and it means you can jump right into the finishing touches of your implementation, such as: Adding health plan-specific rules that meet your business and compliance needs; 2. Vlocity offers robust documentation, training and help for health plan functionality, and we are developing an active community of health plan users. As a provider of applications for the health plan industry, it s our job to document all product features, provide extensive training, and ensure that on-line help is available for all health insurance functionality. And since we provide our products to a growing community of health insurance organizations, you have the opportunity to connect with other users in your community to learn and support each other. In addition, the knowledge generated from that community helps Vlocity direct new feature development towards market trends. Designing the flow to plug into your needs analysis, catalog, or applications, and; Adding your customers, brokers and employees to the system. 4

5 Vlocity Health Insurance: The Industry App that s Ready for Business 3. The Vlocity Health Insurance Team has in-depth knowledge of the industry, and we continuously enhance our software with industry best practices and the latest Salesforce.com functionality. At Vlocity, our team is comprised of experienced leaders from the health plan industry. We leverage our in-depth industry knowledge to build health plan-specific features on top of the Salesforce1 platform. We provide a regular cadence of health insurance updates that are made available throughout the year on a timeline that mirrors the Salesforce release schedule. We also incorporate all Salesforce.com upgrades into the product as soon as they are available, and we provide these updates to our clients at no extra cost. Our applications also respond to new regulatory requirements, up-and-coming packages and new processes. For example, our app tracks employee counts as well as FTEs to check cutoffs for Affordable Care Act requirements, while our plan catalog supports traditional health plan sales as well as private exchanges. In addition, we incorporate foundational best practices that aren t health-specific, but are important for health insurance customers. For instance, we recognize the need to understand a customer s complete history before engaging in a conversation with them. We bring all customer activities into one place, including survey questions, client profiling and needs analysis. These are just a few examples of the kinds of in-depth industry knowledge and best practices that Vlocity Health Insurance brings to the table. Salesforce, Salesforce1 and others are trademarks of salesforce.com, inc. About Vlocity Vlocity is the first Industry cloud software company to deliver multiple industry-specific applications on the Salesforce1 Platform. Vlocity Industry Cloud Apps are modern cloud and mobile software solutions that embed deep industry-specific functionality, best practices and business processes. Vlocity helps organizations dramatically improve their omni-channel customer experience at a significantly lower cost of ownership versus on-premise legacy applications, non-industry specific software, or custom development. Our company is led by executives and founders who helped build winning companies including Salesforce, NetSuite, Veeva, Guidewire, Siebel Systems and Oracle. 5