Our customers tell their stories best; scroll through this presentation to discover Staffing and Enrollment use cases. Discover more at Dell.com/healthplans

1. Our customers tell
their stories best
Health Plan Staffing and Enrollment
Customer Stories

2. Dell - Internal Use - Confidential
Improving agility to meet
unpredictable requirements
Read the case study at
Dell.com/CustomerStories
Published: February 2015 | Expires: February
2017
Business need
HealthMarkets sought a third party that could help its employees
meet unpredictable spikes in workloads and rapidly changing
business requirements including cost constraints.
Benefits
● Reduces the cost of processing 90,000 claims a month by 40
percent
● Lowers the expense of managing 40,000 calls a month by 57
percent
● On-demand, efficient staffing to meet rapidly changing
requirements
● A partner that cares
Solution
The organization partnered with Dell Services to help manage
insurance claims, promptly answer inbound calls from providers
and lower operating expenses.
”We consistently received excellent
service from Dell. At peak times, Dell
Services processed up to 90,000
claims per month, and they helped us
lower our claims processing costs by
40 percent.”
Denise Cotter, Vice President of Operations,
HealthMarkets

3. Dell - Internal Use - Confidential
Delivering secure and
accurate enrollment
and billing data to
14+ state health
plans
Solution
By leveraging 30+ years of
Staffing Experience, and using Dell
Boomi integration platform as a
service (iPaaS), Dell Services was
able to develop the required
enrollment and billing components
in just four weeks and have them
live with several insurance carriers
within two months.
Dell was able to customize the
functions for the 14 health plans
within the two-month timeframe.
Benefits
• Rapid development and
implementation
• Saved $10M+ by automating
processes
• Reduced administration costs for
insurers, helping to keep rates
low for consumers
• Mitigated the risk of compliance
failures and resulting loss of
public confidence in the
exchange
Business need
Members need coverage in the
qualified health and dental plans
offered by the state exchange. And
the data needed to be accurate.
Data needed to be delivered to
14+ health plans in a
standardized, HIPAA 834 & 820
formats for the exchange.
This customer had been waiting six
months for a previous vendor to
properly automate enrollment and
billing. This became a critical need
past the go-live open enrollment

4. Dell - Internal Use - Confidential
Natural disaster
spurs healthcare
teleworking
Solution
• Supplemented disaster
recovery efforts to support
business continuity
• Maintained internal service
levels, helping to meet
year-end reporting
requirements
• Kept 700 displaced
employees engaged and
productive for three
months
Benefits
• Established Teleworking as
a viable long-term model
• Upheld internal service
levels and reporting
requirements
• Improved morale and
productivity of displaced
employees
Business need
The customer needed to
maintain threatened business
continuity through remote
connectivity and re-establish
productivity and employee
morale.

5. Dell - Internal Use - Confidential
Provide flexible
staffing solutions for
a health plan
challenged with
seasonal claims
backlog
Solution
Dell Healthcare Staffing
Services quickly sourced and
recruited over 30 experienced
claims professionals, deployed
Dell equipment mirrored to
customer specifications and
provided team leadership
capable of assisting customer
trainers to get the team up
and running quickly.
Total turnaround time: Less
Benefits
• Rapid response, trusted partner
• Fully screened, Dell employees
• Flexible duration w/possible
redeployment to other areas of
need
• Leverage customer’s existing
systems and technology via Dell
equipment
• No space required or seat
allocation costs at customer
location for increased staffing
• Temp. to perm. available to
customer
Business need
Health Plan sought a third
party that could quickly
provide temporary senior
claim examiners to process
claims resulting in reduction
of end of year backlog.

6. Dell - Internal Use - Confidential
“Dell’s audit service
function brings us to
a higher level than
any of our peer
organizations.”
Solution
• Recruited & trained a team of
dedicated claim auditors
• In conjunction with customer,
completed the required
knowledge transfer to the Dell
audit team
• Assumed responsibility for the
customer’s claim audit functions
• Developed a program to track
and report the audit results
• Established regular customer
meetings to review project
Benefits
• Redirect audit staffing resources
to other responsibilities
• Received a statistically valid
claim audit report from the Dell
Audit Tool to meet management
review and results requirements
• Improved and sustained quality
health claim adjudication for
members and provider partners
Business need
• Develop an independent quality
audit process for medical claims
• Receive statistically valid audit
results
• Continually improve performance

7. Dell - Internal Use - Confidential
A trusted partner since 1999
History with Harvard Pilgrim Health Care
Transitioned
work
Improved
quality
Reduced
costs
Created
stability
Enhanced
collaboration
Trusted
partners
Strengthened
data insights
• Infrastructur
e and Claims
System
Support
1999
2000
2003
2004
2005
2006
2007
2008
• Business
Process
Outsourcing
• Business
strategy and
consulting
• Claims
processing
solutions
(10.1 million
per year)
• Received the
Excellence
Award
• Applications
standardized
• Achieved #1
Commercial
health plan
in America
by U.S.
News and
NCQA
• Application
consolidation
• 2nd year
named #1
Commercial
health plan
in America
by U.S.
News and
NCQA
• Data
Warehouse
solution
• 3rd year
named #1
Commercial
health plan
in America
by U.S.
News and
NCQA
• Extended
contract for
13 years
2009 to
2021
• Re-invest in
dynamic
technologies
and
processes to
respond
to change

8. Thank you!
Discover more customer stories at
Dell.com/CustomerStories
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