Dec 8, 2022
The Noyo Sync standard: What it means to sync member data and why it matters
We think about data synchronization as all of the steps needed to structure, clean, process, and exchange data before it can be put to use. Here's how Noyo makes all of these steps seamless.
Just like clocks need to stay in sync so everyone can be in the right place at the right time, the same holds true for benefits data as it’s exchanged between multiple connected systems, e.g. ben-admins, brokers, and carriers.
At Noyo, we think about syncing data as all of the steps needed to clean, structure, and transmit data before it can be put to use, often referred to as Extract Transform Load or ETL for short. We know this process is where the industry feels the most pain, the amount of work that’s required to not just exchange benefits data but make it useful across the entire business.
The Noyo API is making all of these steps scalable on top of a single, safe platform so benefits software and insurance carriers can exchange enrollment data in near real-time. Unlike other API solutions that can only send data, much like how EDI works today, Noyo enables the ability to look inside the carrier system to confirm changes, audit for issues, and automate other workflows. Each stakeholder has a trusted view of who’s enrolled in what coverage at a given time.
Why is it so important to keep benefits data in sync?
Employee’s lives are constantly changing and small discrepancies lead to big (often expensive) problems. Because today’s technology offers limited transparency, issue detection and resolution are a major operational cost for everyone involved.
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. Additionally, we found that 46% of these issues originated from the broker/ben-admin system while 54% originated in the carrier system. That means, without the Noyo platform, over half of these issues would require feedback from the carrier to reconcile.
And if just one of these errors slips through the cracks, it can take weeks to resolve, not to mention the further downstream consequences that lead to billing errors and claims issues. But the most important cost is the hit to the member experience which has further implications for retention and NPS.
Here are just a few real-life examples that the Noyo platform prevents:
A digit in a dependent’s social security number gets keyed into a carrier portal incorrectly, creating duplicate records and leading to incorrect payroll deductions.
An error in a batch file with new enrollment requests prevents new employees from receiving their insurance ID card for weeks, barring them from access to care. Noyo would immediately flag the error for review, allowing all other enrollments to be processed without issue.
A family shows up to a health provider to find out their HR platform says they’re covered by a plan, but the policy is missing in the carrier’s system, despite the carrier system having previously confirmed the enrollment. The claim gets denied and it takes months to resolve the issue.
In each of these scenarios, the challenge isn't just identifying the issue but how quickly a ben-admin can understand it and resolve it. Today, Noyo’s sync technology automates much of this work, processing member changes and providing confirmation directly from the carrier system within 4 days or less. Additionally, our technology is able to run frequent data audits at the carrier to surface coverage-impacting discrepancies as changes occur.
Where other middleware rely on carrier reports, inferred logic, and blind faith, Noyo keeps data in sync by having seamless integrations with carriers that allow direct read/write access to the system of record.
What syncing data looks like today
By design, EDI and other manual systems cannot support instant, synchronous data exchange. The adoption of application programming interfaces (APIs) is pushing the industry forward, allowing more granular data validation and enforcement of eligibility rules, as well as easier access to data at the carrier. But, not all API solutions are created equally.
When it comes to syncing data, current solutions struggle with these core issues:
The Rube Goldberg effect: A lack of standardization creates a patchwork of custom, siloed data connections. To keep data in sync, it must be structured and transmitted in a consistent way so that the process of aggregating and interpreting data doesn’t rely heavily on human inputs.
Flying blind: It’s impossible to address what you can’t detect. Much of the industry relies on lagging error reports and noisy census data to identify issues. In many cases, the amount of effort it takes to clean and structure data is simply too high to allow frequent auditing. Additionally, today’s systems don’t have useful ways to separate trivial discrepancies from more serious issues that can impact billing or coverage.
Lack of confirmation: This is where other API solutions fall short. When a member change is submitted, most middleware rely on the carrier system to validate the request. If the request is approved without issue, then it's treated as confirmation that the change is completed. However, this isn’t the same as looking directly in the carrier system to confirm the change was fulfilled as intended. The carrier may think they executed a request correctly, but without checking what actually resulted at the carrier against the expected outcome, it's impossible to know if it was right. Keeping data in sync requires fast, direct feedback.
Stale data: Member data is in constant change, and it can often be updated in multiple ways, e.g. in a broker system or directly at the carrier. This makes it difficult for ben-admins to know how accurately their view of data matches the carrier system at a given point in time. Noyo programmatically audits data at the carrier on a frequent schedule, comparing records within the carrier system to records at the ben-admin and making the latest state of data readily available. This is how the Noyo API is able to surface issues before they impact customers, as well as automate key workflows like connecting a group to a carrier, mapping data to the carrier’s account structure, and renewing coverage.
The Noyo Sync standard
The challenge isn’t choosing the right API to improve data quality, it’s choosing the right partner. Noyo provides a roadmap to help benefits companies centralize data operations and transition from sending data via files and other siloed “pipes” to achieving all the benefits of syncing data across a broad network.
But APIs alone won't improve data quality. Without the right automated systems in place, APIs can just move bad data faster.
When we think about the standards required to improve data quality over time, here’s what needs to be true:
Payloads and endpoints are standardized so data can be exchanged and validated in a single consistent format. This includes normalizing all carrier formats into a standardized data format/payload to return to the platform.
Data is in sync between the ben-admin and carrier when it is continuously monitored and refreshed at a regular interval. Noyo’s technology programmatically audits and refreshes data directly from the carrier system without relying on error reports or other “inferred” methods.
All member changes are validated against carrier business rules on submission and then confirmed again directly in the carrier system on the effective date of the change. Today, only Noyo provides true round-trip change confirmation.
Discrepancies can be automatically detected, prioritized, and addressed through a combination of automated rules and intuitive reconciliation workflows.
Want to see how it works? Reach out to our team for a demo!