Healthcare correspondence containing PHI is required by CMS to be managed and produced in a secure and HIPAA compliant environment. This means that all individuals who come in contact with the data must be approved to handle the information.  They must have gone through and passed a series of background checks and adhere to a HIPAA approved workflow.

 

The JPK Secure HealthCare Correspondence Solution relieves the carriers of the headaches associated with managing compliant communications. Whether it is print or some other form of multi-channel message (electronic, SMS text, fax, IVR, etc.), JPK will produce in a secure, HIPAA compliant fashion from composition all the way through production and detailed reporting suitable for audit submission.

 

The type of correspondence varies with the content and reason for the message. Please know that JPK is equipped to handle all communications.  The most commonly requested are found in the following:

 

Letters – Letters can fall into two basic types: those generated through program solutions and letters that are transactional in nature. Both are managed using the CMT-360 platform. The program solution may have one to several hundred types of letter versions, each providing a different message or required action. These documents are housed in a permission based asset library where only approved content may be chosen for output and distribution. The program requires that data files be sent automatically via secure transmission and the letters to be output and distributed based on an established SLA. Automatic messages are sent to the file administrator informing the key staff of receipt of data, any errors in the data, etc.  Piece level tracking is available through the CMT-360 portal, as well as robust reporting on all aspects of the job.

 

The transactional solution is a “one-off” production and distribution of the letter. It might be a letter incorporating variable content to total membership or a static piece with the only variable content being name and address. With this type project running through the CMT-360 system, all the benefits of the program solution are realized – asset library, composition, piece level tracking, reporting, etc.

 

ID Cards – While all member correspondence is important, the member may feel this correspondence is most critical. The ID card provides the member with a document they can carry that shows they have been assigned coverage. The SLA’s may vary but are normally tight and documentation must be kept in the form of reporting that shows the production and distributions were accomplished within compliance guidelines. The CMT-360 platform provides all the necessary tools to manage this process.

 

The types of ID Cards vary from the “standard” 30 mil credit card type to paper cards, which may even be printed off the member’s home computer and printer, with many forms in between. The JPK data management and manufacturing platform is able to produce cards to any of the various production specifications.  And as with letters, production may vary from a transactional member wide, one-time distribution to the production of replacement cards and the daily data fulfillment of new members acquired throughout the year.

 

Welcome Kits/New Member Kits – As a new member, the most important correspondence one can receive from a health plan are an ID card and a Welcome Kit.  The ID card (see above) shows the new member the type coverage, the plan number, important telephone numbers, etc.  The welcome kit EXPLAINS the information on the card and the overall plan details.  And, in some instances, the health plan may choose to include the ID card with the Welcome Kit.  With the importance these documents carry, it is critical to have a reliable partner like JPK producing and distributing…and providing the reporting needed to show all was managed within the compliance guidelines. 

  

Explanation of Payment – The explanation of payment (EOP) is a document that explains to the recipient (either members or providers) why they are receiving a payment.  And, this payment could be in the form of a check inserted in the EOP package or could have been in the form of an electronic transfer (wire, ACH, etc.). Regardless, the recipient is now receiving an explanation as to why the payment was initiated.  The explanation could be a single page or many pages, depending on the complexity of the payment.  As most EOP’s do contain live checks, this type of correspondence requires that a well defined and secure process be followed throughout production, as well as numerous quality control checks and reconciliations be provided for detailed reporting.  The JPK platform, CMT-360, provides all the necessary functions to insure all checkpoints are met and data reconciled.   

 

Explanation of Benefits – Another critical communication the JPK correspondence solution handles is EOB production and distribution. This is a program solution set to run automatically when data files are sent via secure transmission. The CMT-360 platform provides all the necessary piece level tracking and reporting for validation and compliance purposes.

 

ANOC/EOC’s – When it comes to mandated correspondence, none is more critical, or challenging, than the ANOC/EOC packet with its complex composition, production and distribution. Given a mandatory “in home” date (currently September 30th) and an extreme number of variables, this detailed communication package presents many carriers with significant issues. The JPK solution provides a project management module within CMT-360, essential for keeping all participants involved and up to date on the project. In addition, consulting services are available to assist with questions related to CMS regulations and updates. And with several secure manufacturing facilities equipped to handle last minute changes and delays, on time production is never an issue.

 

 Invoices, Checks and Statements – These secure documents are crucial to the financial wellbeing of a company. Processed correctly and on-time helps to ensure prompt payments are made. Incorrect information, excluded content or a “double stuff” results in a disaster. With the quality control systems in place from receipt of data through manufacturing and the proper equipment used for production, from a technical perspective, a double stuff is not possible. Kern technology is utilized and with in-line inserting directly from an imaged roll, it is impossible to commit this egregious error. And volume is never a problem.  Current statement capacity in just one location alone is 50 million pieces per month, with additional capacity to be accessed around client demand. MICR imaging for checks runs at 500 feet per minute at 600 DPI for the fastest, highest quality check printing. Both simplex and duplex check printing is available too.

 

Summary – The JPK Secure HealthCare Correspondence Solution, powered by CMT-360, is the number one, single source for Secure Healthcare messaging of all types and output channels. The benefits of having JPK handle your secure communication needs are many. Please consider all JPK brings to you as the BPO provider for these critical documents:

 

1. Industry knowledge

2. Security and compliance at highest levels

3. Strategic partnership provides “scalability”

4. Strategic partnership provides “best in class” solutions, including CMT-360

5. Outsourcing correspondence functions reduces “pm/pm”

6. Outsourcing correspondence functions reduces the risk, stress and employee time associated with compliance issues

 

If there is value in your secure correspondence, JPK Secure HealthCare Solutions, powered by CMT-360, must be the strategic partner managing your communication requirements.