Some insurance plans have stepped up their communications efforts.
Last year, CIGNA introduced 鈥淲ords We Use鈥� guidelines for all customer communications. 鈥淲e took out all 鈥榠nsurancespeak鈥� and CIGNAspeak,鈥� said chief customer experience officer Ingrid Lindberg, whose position is new.
CIGNA employees are being trained to replace such jargon as provider, co-pay and formulary with approved terms 鈥� doctor, the amount you pay and drug list, for example. CIGNA employees who use a forbidden word donate a nickel to charity.
Aetna has published a simply written paperback book for members called 鈥淣avigating Your Health Benefits for Dummies.鈥� It features breezy language, cartoons about healthcare and even some saucy double entendres. One section heading reads: 鈥淐hecking out your mate鈥檚, uh, benefits package (wink, wink).鈥�
Aetna figures half its members have difficulty understanding and using health information. It鈥檚 a problem especially for minorities, the elderly and recent immigrants, says Dr. Dexter Campinha-Bacote, an Aetna medical director based in Cincinnati. The company keeps its written communications pitched to a fifth-grade reading level. It is revamping its explanation of benefits statements to make them as simple to understand as a bank statement.
Campinha-Bacote says benefits statements badly need improvement across the health insurance industry. CIGNA鈥檚 Lindberg agrees; her company also has redesigned its statements. 鈥淐ustomers want to know, 鈥榃hat did I pay, what do I owe, what did you pay and how much did I save?,鈥欌�� she said.
Health plans increasingly are relying on their websites to convey key information. Aetna鈥檚 site enables members to easily find out how much specialists bill for 30 of the most common office-based services. In April, CIGNA rolled out a Web tool allowing members to estimate total out-of-pocket costs for different services and conditions. It takes into account the deductible, co-payment, whether the medical professional is in or out of the network, the out-of-pocket limit and the amount of money in a member鈥檚 health savings accounts.
The website of Kaiser Permanente, the HMO, teaches members about plan benefits and services. It pulls them into the site by letting them conduct much of their personal healthcare activity online. That includes e-mailing their doctor, making appointments, filling prescriptions, checking their lab tests and accessing their full electronic medical record.
Yet telephone call centers still play a large role in helping members with questions and concerns. Aetna President Mark Bertolini said last year that it costs his company $60 million a year for call center representatives to answer just two types of questions: who is my doctor, and is a particular service covered.