The Role of Automation in Voluntary Insurance Billing Management

Voluntary insurance products serve as a valuable addition to traditional health coverage. These products offer employees the option to enhance their insurance portfolio by choosing from supplementary policies. While the availability of these voluntary benefits is a boon for employees, it presents unique challenges for insurers, particularly billing and payment management.

Automation plays a pivotal role in driving down costs and improving billing accuracy. From streamlining payments and automated retroactivity management to comprehensive delinquency handling and self-administered billing, voluntary insurance billing software introduces automation that improves billing management, ensuring an error-free experience for insurers, employers, and policyholders. 

The Role of Voluntary Insurance Billing Software

As the name implies, voluntary insurance billing software helps automate and improve the billing process for voluntary insurers. Some insurers use internally developed solutions, while others use third-party solutions like Certifi.

Typically, the software includes several features designed to automate and improve the billing, payment, and remittance process. That includes:

  • Integrations with upstream enrollment data sources and downstream general ledger solutions for automated data transfer
  • Invoice generation and distribution via email, web portal, and print
  • Payment processing and application for multiple payment types like check, ACH, credit and debit cards, and retail cash payments
  • Remittance calculation for carriers, brokers, and partners
  • Certifi also integrates rules-based delinquency management, simplifying delinquency notification

Automation Examples

Here are some examples of how to leverage automation in voluntary insurance billing management:

Payment Application and reconciliation

Whether you accept checks, ACH, or cards, automating the application and reconciliation of payments to the appropriate accounts is vital. Technology that includes automated reconciliation of all transactions to compare posted payments with lockbox, credit card, and ACH processor data can save time and reduce errors.

If you manage individual payments, consider technology that can automate payment applications for unknown checks. Individuals commonly fail to send a payment coupon with their check payment. At Certifi, we use machine learning and artificial intelligence to read those checks and determine which accounts likely sent them. A user reviews and makes the ultimate decision. The artificial intelligence learns from that decision for future payments. It’s led to a 4x productivity gain for our customers when reviewing unmatched check payments.

Automated Retroactivity

Insurers often make retroactive adjustments based on changes to enrollment data. For example, if an insurer terminates a policy retroactively, adjustments are made to account for the policy not being effective for the entire billing period.

Automating those manual adjustments can save time and improve billing accuracy. At Certifi, we designed our solution to improve billing accuracy and limit manual retroactive reconciliation by keeping expected credits and debits tied together in every transaction set. That unique feature – what we call Perfect Balance™ – helps to automate as much as 95% of retroactive adjustments that insurers manually process today.

Automated Delinquency Management

Voluntary benefits insurers should have well-defined policies and procedures for handling delinquencies, including adherence to applicable state laws and regulations. Automating the generation of delinquency communications saves time.

Our philosophy involves triggering delinquency letters automatically based on parameters set up in the system – primarily the number of days past an invoice due date. As a result, the process is client-configurable and can be based on a segment or line of business. Insurers can deliver late payment notifications by email or mail, and enable configuration of notification content to meet each client’s unique requirements.

Items such as late fees can be incorporated into the delinquency process, triggering automatic adjustments based on the execution of a specific delinquency event. For example, insurers can add a $50 or 1% late fee if a member or group hasn’t paid an invoice within 30 days of its due date. 

Automated File Processing

Poor data in the billing process can lead to inaccurate billing. That’s where automated quality assurance checks can help to pinpoint potential errors before they impact billing.

At Certifi, we load data from upstream enrollment systems, apply business rules for managing coverage data, and then provide error reporting to help identify erroneous records. Automation helps analyze variances using an established threshold. Variance above the threshold is then manually reviewed.

Automated Self-Administered Billing

Insurers commonly offer employers self-administered billing when paying voluntary benefits. In this scenario, the employer is typically responsible for alerting the insurer to the number of employees applicable to each rate. Then, the billing system generates an invoice that the employer can pay.

Our self-administered billing feature allows an employer to enter any combination of headcount, total volume, and an adjusted rate amount to calculate the amount due for a particular billing period. This functionality allows an employer to default the current month’s numbers to those used in the prior month streamlining the process. It also allows an employer to enter retroactive credit or debit adjustments to previous invoice periods, if the plan’s terms allow.

In voluntary insurance, adaptability and precision are the cornerstones of success. By embracing automation, insurers in the voluntary benefits sector can streamline their operations while enhancing the overall experience for employers and policyholders.

Certifi’s premium billing and payment solutions help voluntary insurers automate billing and payment processes to reduce administrative costs.


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