Does your company have a plan in place for implementing Salesforce health cloud? Do you have the data model and foundation built before expanding or scaling to your partner network and members? Join us for this podcast with Ryan Scott, on how to create a centralized system to manage customer service, brokers, and providers using the Salesforce health cloud platform.
This episode is all about customer success and health cloud—what it is, why it's important, and how to create a strategic foundation that can effectively guide an insurance company and its customer service team to achieve the company's vision.
In the first half of the episode, Kathir and Ryan discuss how they got introduced and how Nteli has been a truly authentic salesforce partner in establishing trust and vision for a medium-size company like Decent and why money doesn't necessarily have to play a role in providing a truly authentic service to customers.
In the second half of the episode, Kathir and Ryan discuss how to set the foundation for Health cloud and how to extract incremental success from your salesforce health cloud implementations.
If you'd like to learn more about the health cloud platform and frameworks used in the episode, you can reach out to healthcloud@nteligroup.com.
For additional resources and services provided by NTeli, visit us at https://www.nteligroup.com/
Nteli Group podcast transcript
Kathir Kuppan and Ryan Scott
August 5, 2020
Music up
Kathir Intro(:04): Hi, this is Kathir Kuppan. I am the co-founder of Nteli, a salesforce.com implementation partner with offices in New York and Houston. Me and my co-founder Bbaesh - we call him BZ- we offer advice and insights to help optimize critical thinking, ROI, and outcomes from your salesforce.com initiatives. Today on the Nteli podcast we’re chatting with Ryan Scott, head of operations at Decent. Decent provides smart health insurance for busy people- finally a new option for the self-employed. They accept members all year round. Here is Ryan telling me how he met my partner BZ in an unusual way...
Ryan(:54): You know working at a startup I wear so many hats. During the open enrollment season, November, late November timeframe, I'm manning a customer service seat on a Saturday night. And my daughter was three-months-old at the time so I had her strapped to my chest trying to get her to fall asleep. And I think it was like 9 p.m. on a Saturday night and a chat pops up on our website and it's BZ and he's asking me questions. We finally quickly get to we don't offer coverage in Houston yet- so BZ you know he's living in Houston- so we can’t offer service. But I said you know let's keep in touch, let me get your information to reach out once we do because we plan to go to Houston, as soon as we can. There was just some... I've been chatting with so many people. There was something about the way that BZ was- he was just responding to me super fast. And his questions were really articulate and really clear and really focused. I just threw in a question ‘you know we serve freelancers and self-employed folks what do you do I'm just curious?’ It's been really cool to be on the front line of operations to get to know other people and he says ‘I'm a Salesforce consultant.’ And I'm in the middle of just this tangled web of how do I represent the complexity of a health insurance business model in service cloud. Every single answer is a custom object, custom relationship. So I had just been stewing on this problem for weeks and weeks. Meanwhile, we're going a hundred miles an hour and I don't have time to really think this stuff through. “I’m a Salesforce consultant.” Oh really? “In the health insurance industry, in the medical industry.” He has experience with this. So that was just ok I can’t serve you but we should talk. So let me get through open enrollment and about a month-and-a-half later BZ and I had a phone call. Then due diligence chatted with a bunch of your former clients. And everything was just raving, glowing reviews. and so here we are I don't know how many months later, at the end of phase one working on Phase 2 of health cloud.
Kathir (3:34): That's a fantastic story Ryan and here we are. So go ahead and tell us more about Decent, please.
Ryan (03:46): Sure so Decent, we're going on two years. We are a third-party administrator, a TPA, for the Techtus Freelancers Association benefit trust- that's like such a mouthful. But really what we're trying to do is be able to offer affordable health insurance to self-employed folks and freelancers.
We think we can offer this cheaper, faster, better and that's what we've been able to do. We've been able to price our plans sometimes 20, 30 40% below the market. And it's offering a service to people who are self-employed, something that they really really need. And then on top of that, you mix in a benefit structure that we actually feel good about offering. There are no hidden traps. There's no fine print that's like a gotcha- that you know you signed up, but now hey guess what you have to pay 100% for X Y and Z. We feel really good about the plans that we are selling. And what that means is that we can put a customer service team upfront that is super passionate about doing the right thing and we just set them free.
Kathir (05:09): You know that’s great. I want to talk about what are the benefits of using salesforce.com as a platform both from a business process standpoint? ... I know you have been a Salesforce user for some time now. You’ve used the service cloud and you have moved on to use the health cloud. So in that shift, I want you to talk about the benefits from a business standpoint. It’s either cost savings or automation, business automation, or analytics... whatever that is. What are the key benefits, business drivers, that made you go towards Salesforce as a buyer?
Ryan (05:45): I initially evaluated the health cloud and decided not to go with it because… I think part of it was because the health cloud paradigm is not that old. Maybe four years old. And when I initially evaluated it two years ago, it just wasn't that built out. And I just saw a bunch of things about utilization management and nurses and we don't have any of those on our staff- so why am I going to pay extra for this stuff? Well then like a year later we realize, the complexities of a household account and an account holder and all the dependents and different coverage periods. Like how do you represent different coverage periods as an object in Salesforce?
If somebody enrolls in one plan and then renewals happen and need to switch to another plan. Health cloud has all this stuff pre-built for us. And then you know, I haven't even mentioned the complexities of provider data. Provider data, it's the most tangled rat's nest that I've ever seen. And everybody that I talk to in the healthcare world, as soon as you mention provider data, ‘oh yeah, I've been there. I know exactly what you're talking about.’ So health cloud comes pre-loaded with a data structure that was going to take us weeks and weeks to build out with custom objects. And then the problem is what happens when you need to change something, you have to update this and maintain it.
Kathir (07:23) : The cost of maintaining custom objects, it’s underrated. Many people don't know because it works. You can see that it's working. Functionality is there. But then you might have written something on top of it. The developer might have used one methodology to do it. But having out-of-the-box functionality really works. Because you grow along with the product The product is going to mature. Because there are thousands of customers Salesforce has and you’re getting all the benefits in the sharing economy. I call it the Salesforce multi-tenant shared economy. You get the benefits of other customers. I think from that standpoint I think that’s the right choice- you made the right decision.
We always say- me and BZ, my business partner. When we find customers, we’ve started saying no to- a lot of customers. We look for a template. We always say ‘is this Ryan Scott.’ If he doesn't fit the bill then - no.
So in this world of consulting and freelancers, it’s fantastic to find a fit where we’re aligned in a way that it benefits us in improving our business, our quality.
And also help the customers get over the hump without too much of a cost or undertaking on their side. I think that’s where we find the fit and we have loved every inch of it.
Ryan (09:17): I want to talk about this for a second because I think this is really important in who Nteli is. So in the initial scoping phase where we were just talking about is there an opportunity for a project, what should the scope of the project be? I teed up to you guys build-out, duplicate the health cloud model from scratch. And that would have been probably been locking Nteli into continuous maintenance, more projects. It was going to be more money, more projects. And you guys came back pretty quickly and said, we're not even going to scope this. Like we don't even recommend going down this path, just go with the health cloud. Cause it's going to get you what you need way faster. And you didn't make any money off of that. That really rang out really loud for me about your integrity and your alignment with delivering value, in a way that I trust. And it meant a lot to me. You know if you had come back and said we think that we can do this, I would have considered it. So it it really speaks a lot I think to the type of work that you guys believe in doing.
Kathir (10:51): Thank you for saying that. We have seen this time and again where we go into a project and then the customer is driving the initiatives. Not only from the business side but also from the technology side. And I have personally worked with Aetna, Blue Cross Blue Shield, and Humana. All these experiences in 15, 20 years, time and again… I have also worked with a "product" company. When product marketing is done right especially with Salesforce doing things right, if you align with their strategy and understand what they are doing, you can pretty much help every customer along the way.
What would have happened if we had taken the other route is two years later you would have had a behemoth of a Salesforce system in your hands. We would have made maybe a couple of hundred grand more, but that doesn’t translate to a meaningful service. Or a trustworthy partnership- we call it in this business. That goes a long way. And culturally we have both told ourselves we will walk away from deals if needed if it doesn’t align with what our recommendations are. Because our recommendations are in the best interest of the customer.
So now you have a health cloud. You have taken on the health cloud now. We are moving onto other bigger initiatives with health cloud. But if you could quickly tell us the benefits that you’ve gained already or you’ve seen that you will gain with this implementation. It will really benefit who is listening to the podcast because lots of customers are in your shoes. Especially where health cloud is today. There is this black box that a lot of people don’t really understand what it does. But they know it does something. So help us understand that from your perspective.
Ryan (13:02): So I think it's good to have the context of how far I've come since starting in this role. I have not used a CRM prior to being at Decent. And what I've learned is that when you start from scratch as an organization with Salesforce, you get a giant box of Legos, Lego pieces. And you have to go somewhere else to find the instructions on what to build, but you have to make it work for your organization. And I understand, that’s intentional because no organization is the same as any other.
And it's really hard to put all this stuff together and to build it out and then to have data flowing into Salesforce in a way that's automated is also hard. And then you know you think about the complexities of your own industry, in your own business. And you I can talk about the health insurance world- there are just so many relationships and objects and entities.
We couldn't even take on the integration project until we got all of our data structures and models and like people representations in Salesforce set-up in a way that was ready to catch it. So what we went through as a team during open enrollment last year growing by 10x ..was so many manual processes. We were manually copying and pasting members' names and addresses and member IDs and phone numbers from our are like homespun products user interface into Salesforce. The biggest thing that I've been pushing for this year is we have to get some automated integration where data is automatically flowing from our product back-end into Salesforce. Otherwise, the wheels are going to fall off this bus. Because we're aiming for another 10 x in open enrollment.
And for us to be managing, for you know the customer service team managing the sales calls and also at the time we have current members you need health care. And you know they’re stuck in some imaging centers front office being told that their benefits aren’t like... whatever is going on. We're trying to solve those problems and put out those fires. We’re about to have open enrollment layered on top of it. I'm just trying to get some of the stuff automated and the fact that we're almost done now. You know we’re at the end almost at the end of phase 2.
Whereas first, let's actually look at all the Lego pieces that came in the box and make it work for us. And now we're ready to integrate with our product and we're about to wrap up that project. Turning this on in production where data is going to start automatically flowing into Salesforce as soon as somebody clicks that enroll now button and here's my payment info- it’s just going to automatically populate it. This is not technical at all but what I am really excited about is the meeting when I can go to my customer service team and tell them you don't have to lift this boulder anymore. Like peoples, shoulders are going to drop and there's probably going to be happy tears. Because of this massive amount of work that we've been just, you know we’ve just been muscling it through. But it's been taking us away from the high touch stuff.
Kathir (16:36): You could be talking to customers. Figuring out what the best plans are for them or even finding them primary physicians and all that stuff. That’s fantastic because a lot of time we focus on the data model and integration and everything. But you hit it right, the customer service aspect of insurance companies. If we can take some weight off their shoulders.. Cause working in customer service insurance companies, you don’t hear a lot of good stories.
Ryan (17:24) : It’s a thankless job. A lot of it is because the systems are terrible. There is so much control F.
Kathir: And the change management associated with it. Training people to do one thing after another. All that with automation it changes it. I am extremely happy to hear this. This is a great story to be able to talk to people about how customer service benefits from the health cloud. We talk about three-way relationships but forget all that. This is the main thing that it solves.
Ryan (18:03): There is some cool stuff. We are still as a company, Decent is still learning how to crawl. Like I'll be honest we're still learning how to crawl. The basic stuff of having our data model represented accurately in Salesforce that's like table stakes. And then enabling automation of the data just getting pushed in so we're not copying and pasting, also table stakes, but that's what being at a startup is like. But what this is going to enable is having our shoppers represented in Salesforce, our brokers represented in Salesforce, our members, our providers. All of these entities are interacting with each other and what it’s enabling us to do is give our head of broker relations a dashboard view into things like- these members had their payment fail. Our head of broker relations gets visibility to that on day one and then he can go follow with brokers because they've got a much more you know personal relationship with our members. So we can make sure that we catch all this stuff right away and just like unblock everybody. And just sharing information across this platform it's been so cool to see all of these things just unlock right away. And then there is just all this fancy stuff that we're going to get to do because this foundation is there.
Kathir (19:32): Actionable insights, they use the word, everybody in CRM. But what we forget is without setting the foundation and the data model right- and the flow of the product data from your "product" systems into Salesforce. You are not going to get actionable insights. So I feel like your foundation is fantastic and you guys are heading in the right direction. And it is crawl. We’ll get there for the actionable insights very soon.
So Ryan I want to thank you.
Ryan: Thank you Kathir.
Kathir Outro (20:08): If you are a healthcare organization or a hospital system looking for more insights let us know here by commenting on this conversation. Or email us at healthcloud@nteligroup.com.