IntroductionDalbar, Inc. is now accepting submissions for its annual Explanation of Benefits Statements program. Now in its 3rd year, Dalbar’s Trends and Best Practices in EOB Statements programevaluates EOBs in relation to member statement preferences, the industry’s best practices, regulatory requirements, and technological advancements.
The result of the analysis is a comprehensive report ranking EOBs, spotlighting the industry’s best, and summarizing practices that drive positive member behavior. Rankings and reports are included in the industry report.
What is the Trends and Best Practices in EOB Statements used for?
- Identify best practices
- Improve the EOB's effectiveness
- Reduce production costs or other related expenses such as:
- Volume of calls to the call center
- Volume of paper through better design
- Better understand and promote more expeditious use of healthcare services
- Support the case internally to redesign or update the EOB
- Promote success and create a competitive advantage where applicable
What is included in the Reports? Industry Report:
- Current trends and challenges in design and content
- Industry best practices and relevant recommendations
- Leadership qualities that distinguish the top ranked EOBs
- Ranking of Explanation of Benefits
- Criteria used to evaluate EOB
Executive Summary of Findings and your EOB’s Rating includes:
- The ranking your EOB achieves
- Industry benchmarks to provide context for your EOB’s score and rank
What is the Method? EOBs will be evaluated and rated using Dalbar’s Evaluation Criteria. The Evaluation Criteria for EOBs are based on:
- Stakeholder Preferences
- Regulatory Requirements
- Industry Practice
- Communication/Design Best Practices
Each EOB is rated in three categories:
Clarity: Determines whether the content is presented in a manner that can be easily understood and is relevant.
Content: Determines whether all required content is present and is additional content presented in a way that will help readers put the EOB information into an overall context (e.g. targeted messaging).
Design & Available Formats: Elements that enhance the readability and understandability of the statement, such as charts, icons, and font size and style.
What is the Timeline?All Explanation of Benefits must be submitted by December 30, 2011. The report will be released at the end of 1st Quarter 2012.
What is the Cost? There is no cost to submit your EOB for inclusion in the report. In return for submitting your EOB, you will receive a complementary Dalbar Scoring Report customized for your statement. It will include the evaluation score your statement received and compare that to the industry statement average. You will also receive your rank out of all statements evaluated. In addition you will receive the scores your statement received for Clarity, Content and Design & Statement Formats. These will be compared to the industry average, the industry best and the maximum scores possible.
For companies who purchase the report on or before April 1st 2012, the cost is $2,500.
For companies who purchase on or after April 2nd 2012, the cost is Cost is $3,500.
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