A company’s open enrollment period is always a busy time for HR teams. To offer insights and tools during this stressful season, Eden Health has published a free guide, Navigating the Benefits Maze. You’ll learn how benefits navigators work with patients to provide healthcare guidance and help them save money. In this blog series, we’ll meet some of Eden’s own benefits navigators, also called Clinical Associates, and hear why they love being able to give patients advice – especially during open enrollment.
What do you like most about being a Clinical Associate?
When patients have issues with insurance coverage, I like being their advocate and knowing how to solve these problems, because they have no idea where to start. For employees, it’s hard to find even an hour to get on the phone with insurance. And even if they can, it’s a lot of back and forth and coordination that they don’t want to deal with. For me it’s a simple fix to identify, say, a coding error and determine what the solution should be. And I like being able to help patients in this way.
To some of us, having to cover an extra $25 on a bill doesn’t seem like a big deal. But when a patient tells us it makes a huge impact for them to get that erased, it makes all the calls and dealing with the insurance reps totally worthwhile.
How are you providing help during COVID-19?
Obviously, a lot of patients right now would rather not go to a physical office if they don’t need to. Luckily, they can now get virtual care. I enjoy helping patients figure out what virtual care benefits their insurance covers, so they can see a provider without having to go anywhere.
How do you support employees during open enrollment?
When employees are figuring out their next plan, traditionally they would go to HR with questions. With Eden Health, they can just come to us on the app and say, “Hi, I want help picking a plan.” We have quick response times and individual, one-on-one attention. We’ll get on the phone or a video within minutes to just go over everything.
How do you help them pick a plan? What’s the process?
We ask a lot of questions! Our first one is always, What are your priorities? Then: Is cost your biggest concern, or do you care more about having access to a wider variety of providers? Are you looking into an individual plan versus the family plan? Do you want to pay more upfront per paycheck to potentially save money down the line, or are you looking to pay less per paycheck now? If you have a medical emergency, are you willing to pay a higher deductible later?
When they need us to, we take time to explain the differences between deductibles, premiums, insurance copays, and so on.
Can you just select the right plan for each employee?
No. At the end of the day, we can’t actually choose the plan for them or say, “we think you should pick this.” That’s really going to be their decision. But what we can do is guide them and explain how the different plans work, which ones will cost them more now versus later, or which ones have better coverage for a wider range of providers. What we can do is talk them through all the variables to help them decide on a plan. But ultimately it’s their call.
How do you like working for Eden Health?
Eden Health is a company where I feel like I use my skills and abilities to their fullest potential. I also receive really great feedback, not only from our patients, but also from the company and the other people I work with. I love working here honestly—I never want to leave!
