How HealthJoy Gets in Front of Healthcare Decisions

For an employee, navigating the healthcare system is just a series of difficult decisions. With unclear pricing and confusing deductibles, it’s no wonder benefits frustrate employees. This leads to costly healthcare decisions that affect both employee and employer.

Over the years, benefits consultants and companies alike have tried to tackle these issues. We’ve seen increased deductibles place a heavier burden on employees to shop for care. We’ve added more point solutions such as telemedicine to drive cost-containment strategies. Yet benefits are still confusing, and utilization is low..

Benefits information isn’t readily available when employees have to make a choice about care. First, they have to find their benefits booklet, which is likely buried in a drawer. Second, they need to figure out the best vendor and correct number. Lastly, they have to make the call to the provider and wait on hold—sometimes for hours.

Yes, the employee benefit experience is broken. But it’s still possible to make smart healthcare decisions. In some cases, it’s even straightforward. The key lies in preparation. So in this post, we’ll tell you how HealthJoy gets in front of those decisions to help employees make smarter healthcare choices.

Facility and Provider Recommendations

Sometimes you just know what you want. In a time when you can customize your sneakers, your vitamins, and your shampoo, we expect the same from healthcare providers. Most health insurance carriers and even third-party sites offer plenty of levers to help employees pick the perfect provider…if they’re willing to sacrifice their time.

Most of your employees aren’t. Instead, they’ll choose a provider or facility based on their doctor’s recommendation, location of the provider, or on the advice of a friend. With both cost and quality varying so much, a poor provider selection can cost your plan hundreds or even thousands of dollars.

Our provider recommendations offer your employees an easy experience. We’ll recommend an in-network provider that meets their unique qualifications, from specialty and experience to gender and location. We’ll give them a clear picture of what it will cost and book an appointment on their behalf. 

Claims Data

Your claims data is a rich source of information about employee behavior. We’ll help you use it to drive behavioral change across your employee population.

Self-funded companies working with a Third Party Administrator (TPA) have access to HealthJoy TPA+, an enhanced level of service that unlocks claims data. We're able to see a member's preauthorization and precertification requests and reach out if the procedure they're considering would be less expensive at a different facility. 

Claims data is gold for self-funded clients, but there’s still plenty we can do for clients on fully-funded plans to prevent annual premium sticker shock.

Our Benefits Wallet

Here’s a familiar scenario: you show up your doctor’s office. You fish around in your wallet, thumb through your cards, and realize—nope—your dental insurance card is not there.

Our benefits wallet was designed to make that moment of panic a thing of the past.

Imagine all your employees’ benefits cards in one always-available digital location. We’re aren’t just talking about your health insurance card. Your company works with our implementation team to include whatever benefits you want to add to your wallet. That means the benefits wallet includes dental, EAP, 401k, HSA, pet insurance, and more. Your employees will never experience that panicked waiting-room-wallet-rifle again.

The benefits wallet also serves another useful purpose: it keeps benefits top-of-mind. Most employees don’t know how to access benefits like EAP and telemedicine. They might not even know they exist at all. That’s terrible news for utilization and cost-containment strategies.

The same is true of plan details. Employees can’t make smart healthcare decisions when it’s tough to find their out-of-network copay or see what an ER visit costs (see Why Tackling Benefits Awareness is Vital for Your Company for more).

Our benefits wallet displays all this information and more. It even securely pulls balance information from members’ HSA, FSA, and 401k accounts. It reminds employees of their benefits every time they open the HealthJoy app.

Pharmacy Guidance

Prescription drugs account for almost 20% of the average company’s healthcare spend. Yet most employees, and often their doctors, are confused by prescription coverage.

Say an employee receives a diagnosis of high blood pressure. Their doctor prescribes a statin drug, and the employee fills the name-brand prescription at their favorite local pharmacy. They’re scared of heart disease and eager to start managing their symptoms, so they definitely aren’t thinking of alternatives. They pay hundreds out of pocket each month for refills. While they’re focused on changing diet and lifestyle, they don’t know there’s room to save.

In this situation, a little education goes a long way. Our virtual assistant, JOY, regularly guides members through prescription savings strategies. She also educates them on their pharmacy benefits. We’ll help them select a regular pharmacy within your preferred pharmacy provider (PCP) program or find one while they’re traveling.

Employees might not be sure about their prescription costs. When that’s the case, a quick review by our medication team can clear up any concerns. We use nine different strategies to look for savings, so these reviews almost always uncover opportunities to cut costs.

JOY

Ever wish someone would remind you to check off all those benefits-related to-do’s? Maybe you’ve put off adding a spouse to your plan, scheduling that annual wellness screening, or getting that flu shot. Your employees want to take action, but life gets in the way.

JOY helps employees tackle these tasks every day. Our virtual assistant is the first face employees see when they download and open the HealthJoy app. She uses push notifications and custom chat campaigns to educate, remind, prompt, and encourage.

Like our benefits wallet, JOY is great at keeping benefits top-of-mind. She’ll pop into a member’s home screen to remind them that HealthJoy can review medical bills. When a bill arrives a few months later, they’ll remember where to turn (see Why It’s Critical to Have Medical Bills Reviewed for more).

This scenario is one of the ways JOY drives utilization and creates satisfied employees. By encouraging members to take proactive steps, she makes sure they’re informed and ready when they need to decide on their healthcare.

Healthcare Concierge Support

We’re all in on the power of AI-driven help (if you’re reading this, JOY, don’t panic!). When you’re frustrated by an unexpected bill or want to chat about your HSA, though? Nothing beats a reassuring human voice. Our expert healthcare concierge team is there for your employees when they need complex answers. They help your employees choose care that balances cost and quality.

They’re masters at finding new ways to save on healthcare and help your employees choose care that balances cost and quality. 

HealthJoy gets in front of healthcare decisions

Smart healthcare decisions are straightforward when your employees know what to expect from their benefits and how to make the most of all you offer. HealthJoy makes all this possible. We use live support and personalized recommendations to bring clarity to a complicated system. Get in front of healthcare decisions with HealthJoy’s healthcare navigation platform.