Company Name: Assisted Living
Industry: Healthcare / Life Sciences
Sub-Industry: Provider
Products Purchased: Salesforce Health Cloud, Salesforce Marketing Cloud, Data Cloud, Unified Health Scoring, Integration

Introduction:

Assisted Living is a Medicare Advantage Plan Company that creates products specifically tailored to those living in Long Term Care, Assisted Living, and Memory Care facilities, intending to provide members with high-quality benefits, care, and comfort. 

Assisted Living collaborated with Salesforce and CopperHill to usher in a new era of streamlined healthcare management. The comprehensive solutions deployed will address challenges spanning intake, compliance, automation, and data management. These improvements will significantly enhance operational efficiency and compliance adherence. With future plans focused on deeper integration, enhanced data quality, and streamlined application processes, Assisted Living continues to pave the way for a more efficient and patient-centered healthcare management system.

Challenges Addressed:

Assisted Living has faced several operational challenges, prompting them to seek opportunities for improvement. One key area in which they are actively working to enhance their processes is the management of new leads and members. They are in the process of streamlining these procedures to ensure a smoother enrollment experience. Furthermore, Assisted Living recognizes the importance of data integrity and is actively exploring ways to improve its data management practices, aiming to provide more real-time accessibility in the future.

Managing permissions to contact members while ensuring regulatory compliance posed a complex and necessary task for Assisted Living. The intricate qualification process for insurance plans demanded extensive manual effort and specialized expertise, adding to the operational challenges. The organization also faced difficulties in accurately tracking and documenting sales interactions, impacting comprehensive customer relationship management.

HIPAA compliance requirements further accentuated the need for efficient data protection and management solutions. Assisted Living’s reliance on fax communications for information exchange in healthcare introduced obstacles in terms of speed and accuracy and impeded communication.

A significant challenge involved managing patient relationships and related individuals’ information. The organization struggled with unifying systems and data across various facilities, operating in isolated silos. Additionally, its appointment scheduling process was inefficient and time-consuming.

Solutions Implemented:

• Intake Process and Permissions: The Assisted Living data lake is housing resident data from all Assisted Living facilities- each with their own EHR instance. CopperHill worked with Assisted Living on an integration that pulls that resident data into Salesforce, and pushes details back to the data lake including completed application information.
• Qualification Automation: Automation based on Medicare eligibility criteria enabled seamless lead creation, simplifying the sales process.
• Scope of Appointment Compliance: A dedicated scope of appointment object and a user-friendly documentation button streamlined compliance with regulations and provided a centralized repository.
• Application Automation: Assisted Living automated the insurance application process, integrating FormTitan for form creation and data synchronization with Salesforce, reducing manual data entry.
• Fax Solution Integration: Integration with Concord Cloud Fax enhanced communication efficiency by automating data extraction from HIPAA-compliant faxes using AI and OCR capabilities.
• Health Cloud Functionality: The implementation of patient cards and timelines in Health Cloud enabled easy access to patient information, conditions, and allergies, streamlining data visualization.
• Appointment Scheduling: Customized Salesforce Scheduler improved appointment scheduling by automating assignment, considering various criteria like appointment type and facility selection.
• Marketing Cloud Integration: A Marketing Cloud landing page facilitated permissions to contact, while personalized journeys enhanced communication and education through tailored emails.

Future Considerations:

In a future phase 2, Assisted Living is poised to continue to enhance its operational landscape. They plan to explore integration with Salesforce and the Centers for Medicare & Medicaid Services (CMS), streamlining the application submission process for improved efficiency and client satisfaction.

Assisted Living aims to bolster data management practices by standardizing patient information and related fields, fostering accuracy and consistency. This initiative is pivotal in ensuring reliable insights and informed decision-making. Additionally, Assisted Living is considering the adoption of Salesforce’s Unified Health Scoring (UHS), powered by Data Cloud, to elevate data quality, providing comprehensive insights into patient health for more tailored and effective care strategies. These forward-looking approaches reflect Assisted Living’s commitment to refining healthcare management and offering exceptional services.

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