Dec 15, 2022

Transparency into every member change: How round-trip confirmation puts ben-admins in control

Noyo is at the forefront of helping solve the industry's data quality issues with our benefits data platform. Here's how one of our power data sync capabilities works.

Today’s technology doesn’t make it easy to understand the real-time status of member enrollment and eligibility data. When benefits software platforms submit member changes to the carrier, they rarely know if those changes were completed as intended. Errors like incorrect employee demographic information (social security number, birth date, etc.), coverage date discrepancies, and missing enrollments are far too common.

This lack of visibility results in poor member experiences and high operational costs as internal teams face a constant stream of billing and coverage issues.

Noyo is at the forefront of using modern technology to catch and resolve data quality issues before they become problems. One of the most powerful features of our Noyo Sync technology is round-trip change confirmation, which delivers full visibility into the status and completion of every member change.

To date, only Noyo offers round-trip confirmation at scale. We’ll dive into the details of how it differs from other solutions, and how it puts brokers and ben-admins in control.

What is round-trip confirmation?

Round-trip confirmation is a unique feature of our Sync technology. It’s how our platform confirms that a requested member change was processed successfully in the carrier’s system, providing an automatic feedback loop direct from the carrier.

Instead of file-based workflows, ben-admins send member changes to our API endpoints for managing enrollment and eligibility. For every change that’s submitted to the Noyo API, round-trip confirmation provides two checks:

  1. First, we validate the request up front to enforce carrier eligibility rules and data requirements. Once the carrier has received the change, we'll confirm the status and expose it via API or in our dashboard interface.

  2. Then, we check a second time in the carrier’s system on the change’s effective date and compare the result to what the ben-admin was expecting. If we uncover an issue, it's immediately surfaced for review.

With Noyo, brokers and ben-admins can process changes within 4 days or less and then receive automatic confirmation that each change was completed correctly.

No more waiting on the carrier, sifting through hard-to-read EDI error reports, or relying on customer escalations to uncover issues; just a simple, automated step that takes the guesswork out of dealing with black-box carrier systems.

How does Noyo round-trip confirmation differ from other solutions?

EDI and other API middleware aren’t able to sync data directly from within the carrier system, and therefore cannot support round-trip confirmation. Noyo is able to do this because of the proprietary integrations we have with insurance carriers, which support near real-time data exchange between the carrier and connected software platforms.

Other solutions may be able to submit and validate member changes over API and confirm that the carrier has accepted the request, but this is not direct confirmation that the request was implemented correctly. While it can be an improvement on EDI, it’s only half the journey and there’s still a lot that can go wrong after a change is accepted by the carrier.

Here are a few examples:

  • A change happens on the wrong date because the carrier system has different rules than the benefits software.

  • A broker or member makes a change directly with the carrier that the benefits software doesn’t know about.

  • A change fails to process after being accepted by the carrier because something went wrong with an internal workflow or issue with their system.

How common is this? After onboarding a sample of 332 groups representing 46,000 policies, Noyo’s sync technology found an average of 44 issues per group that could directly impact member coverage, with 95% of groups having at least one coverage-impacting error. We also found that 54% of issues originated in the carrier system. The largest category of issues was a missing employee policy at the carrier, meaning the ben-admin was expecting a policy to exist and Noyo checked back into the carrier system to discover that it didn’t.

Once member data is accepted by a carrier, if a ben-admin is relying on EDI or other API middleware, they must wait for the carrier to parse member changes and send an error report for confirmation — if such a report is provided at all.

This can take days or longer and requires ops personnel to review the report, implement the changes, and submit the data back to the carrier to be processed once again. Meanwhile, affected members are stuck waiting, unable to access their benefits.

How does round-trip confirmation work?

Every benefits software connected to our network of Sync carriers is equipped with round-trip confirmation for every member change. This includes the ability to monitor the status of each transaction, as well as tools for issue identification and resolution all in one, easy-to-use dashboard experience.

Round-trip confirmation is made possible by:

  • Deep carrier connections. When Noyo integrates with insurance carriers to enable data sync capabilities, we build proprietary integrations with their systems. This allows direct read/write access to the carrier’s system of record in near real-time.

  • Requests broken into sub-operations. When you submit a member request, you’re telling Noyo what successful enrollment looks like. Noyo then does the hard work of structuring the request into smaller transactions or action items that are carried out at the carrier. For example, a New Hire Enrollment member request may result in two member transactions; one to add medical coverage at Carrier A and a second to add dental and vision coverage at Carrier B.

  • Change monitoring in the Noyo dashboard. Our technology proactively surfaces issues and provides recommendations on how to resolve them in a fast, simple workflow. The Noyo support team is often able to resolve issues as they arise without customer input. If external review is required, every issue is viewable and actionable in the Noyo dashboard.

The benefits of round-trip confirmation

Round-trip confirmation provides transparency at scale for every member change. With Noyo, ben-admins can deliver a faster, more reliable experience to their clients, and carriers can offer a seamless, differentiated experience to members that’s less work for ben-admins and brokers.

Round-trip confirmation serves everyone in the benefits ecosystem

  • Customers: Fewer coverage-impacting issues means employers and employees can access benefits when they’ve been promised, improving customer satisfaction.

  • Ben-admins: Clean, accurate, and synchronized data puts ben-admins in control of how to respond to issues, reducing workloads for operations teams and automating issue reconciliation.

  • Brokers: Better data creates better customer experiences, like being able to address enrollment issues with the carrier — improving renewal cycles for brokers, while helping them keep customer trust.

  • Carriers: Integrating with Noyo lets carriers process and confirm enrollment and eligibility changes in four days or less. So they can give ben-admins the transparency they need and want.

Ready for transparency into every member change?

APIs are transforming how the benefits industry exchanges data, but they can’t solve data quality problems alone. Noyo is setting the standard for what it means to keep benefits data in sync, achieving new levels of data quality and speed.

If you do benefits, you need Noyo

The future of employee benefits is faster, easier, and more automated. Are you ready?