Driving Compliance and Efficiency
Johns Hopkins Health Plans Leverages AI for Superior Member Care
HANOVER, MD – The No Surprises Act created transparency for patients and protection against unexpected billing, but it also brought new compliance requirements that left many health plans scrambling.
By adopting InsightPro from MDI NetworX, Johns Hopkins Health Plans (JHHP) has significantly streamlined operations and ensured member-focused compliance with the No Surprises Act.
“We are committed to providing the best possible health care experience for our members,” said Ryan O'Donnell, Chief Operating Officer for Johns Hopkins Health Plans. “Using innovative technology ensures that our members have access to accurate, up-to-date provider information, simplifying their care journey and promoting trust in our services.”
Powered by AI, the analytics platform has already yielded significant benefits for Johns Hopkins Health Plans, including:
- No Surprises Act Compliance: Ensured timely updates to provider directories, resulting in improved transparency for patients and minimizing billing confusion.
- AI-Driven Insights: Provided robust progress tracking and quality assurance capabilities to limit errors in directory listings.
- Reduced Appeals and Member Grievances: Decreased claims showing incorrect member cost-shares, promoting a smoother member experience and reducing member and provider abrasion.
“As a managed care organization administering government programs, compliance with laws and regulations is critical,” said John Wells, Executive Director of Compliance for Johns Hopkins Health Plans. “Technology that reduces errors and improves quality assurance makes us stronger for those we serve.”
Since implementing InsightPro, JHHP has significantly streamlined operations and ensured patient-focused compliance with the No Surprises Act