Computer programmer using data and integration to help health plan members

How Data and Integration at Blue Cross Is Driving the Future of Member Services

There’s a popular analogy of a swan swimming in a lake: from a vantage point on the shoreline, the swan appears to glide effortlessly across the surface. But underwater, the swan’s legs pump back and forth, nonstop.

This seemingly invisible powerhouse is a great way to describe how data and integration works at Blue Cross Blue Shield of Michigan to provide a seamless, intuitive experience for members.

Blue Cross has served the state with high-quality health insurance for more than 80 years. Today, Blue Cross isn’t just a health insurance company. It’s a digital and data analytics company.

In modern health care, data is abundant as providers and hospital systems have adopted digital record-keeping systems. Processing this digital information on members and claims takes a powerhouse of technology, as information is relayed and processed in real-time from multiple systems and sources. Integrating this data into a format that can be analyzed and understood enables Blue Cross to deliver the products, services and solutions that members want and need.

Inside Blue Cross, we’ve built an Advanced Integration Hub to unlock the potential of real-time data. This requires the use of cutting-edge technology to securely transfer information, leverage cloud storage and stream data.

“As a result, we’re able to deliver a high-level of customer service for members when they interact with Blue Cross and Blue Care Network – whether it’s accessing their account information online or calling a customer service representative,” said Paul Horalek, vice president of Enterprise Technology Strategy and Services at Blue Cross. “We’re providing our members with the real time data and insights needed to make more informed decisions about their care.”

Here are two examples of ways data integration is helping members:

Blue Cross Coordinated Care

  • This program analyzes member activities to anticipate their health care needs. We’re able to digitally deliver recommendations and advisories to members, as well as provide direct access to member advocates and nurses.

Increasing access to member data

  • Members have 24/7 access to their account information at Blue Cross and BCN. They can log in to their member accounts online at bcbsm.com, or access the Blue Cross mobile app. In both locations, members can find a digital ID card that is always up to date.
  • Through their member accounts online and on the app, members can find records of their explanation of benefits, claims, payments, referrals and prior authorizations. They can also review their plan coverage to research drug and procedure costs and find in-network providers for medical, dental and vision. Access is also available to our 24-Hour Nurse Line and telehealth services.

As Blue Cross continues to leverage modern technology and new ways of working, we’re enabling better services for members now and into the future.

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Photo credit: Getty Images

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