"In today's customer service environment, I can't imagine going back to doing claims investigation in-house. It would simply make no sense." Rick Bond, Director of Benefits

Challenge

The NiSource operating companies deliver energy to nearly four million customers in a high-demand energy corridor stretching from the Gulf Coast through the Midwest to New England. As the company works toward its long-term goal of becoming the premier regulated energy company in North America, there is a business imperative to operate more efficiently and effectively. This approach comes naturally to the NiSource Human Resources group, who embraced outsourcing several years ago as one way to improve the delivery of employee benefits.

The move to an outsourced model freed the lean HR team from day-to-day benefits administration, but their time was still being drained by the inevitable claims investigation process. Making matters worse, the claims investigation process was becoming more unwieldy. Health providers streamlined their own customer service operations, funneling inquires through online systems and centralized call centers. While this was more efficient for the providers, it was more difficult and time-consuming for the lean NiSource HR staff to navigate the system.

Solution

NiSource was quick to sign on to Hewitt's Advocacy Services as soon as they became available and they haven't looked back since. Hewitt's Advocacy Services leverages existing telephony and technology infrastructure, workflow tools, and extensive expertise working directly with health care providers, collection agencies, and health plans to resolve questions regarding access to care, plan provisions, billing, and other claim issues. It was clear to NiSource that Hewitt's Advocacy team provided the solution they needed to improve the efficiency of the claims resolution process while providing participants with the customer service they deserved. It allows the NiSource HR team to focus on other priorities, plus removes them from the middle of the decision-making process and leads to more objective oversight of  the appeals process.

Results

The HR team is frequently reminded of how much they appreciate the Advocacy Services team: Each time a request for a claims investigation comes into HR, they forward it directly to Advocacy Services with complete confidence that the employee's question or issue will be resolved quickly, professionally, and accurately. Using Hewitt's Advocacy Services helps NiSource to maintain strong relationships with their plan providers, as well. The reporting provides useful documentation and highlights trends or plan provisions that need attention; it also helps to ensure that the NiSource team doesn't overreact to isolated incidents. Finally, using Hewitt's Advocacy Services helps to protect the confidentiality of the employees.  Both employees and HR staff alike prefer not to have in-house HR involved in potentially sensitive health issues. And this, Bond says, has the added advantage of serving as a bridge to HIPAA compliance.