Don’t Settle

Most of us in the game came up through sales positions where we were isolated from operations, and our relationship with our employer was about money. Sales is responsible for revenue generation, and I was always hungry to make money, so the relationship was comfortable and made sense to me. My perspective on this has changed since working at ClaimDOC. They have pushed me to care about more than money. As I’ve grown to care about the community aspects of our company and clients, it has made me better at my job. The comfort created by removing phony exteriors allows internal and external relationships to thrive. It’s hard to explain, but we aren’t alone, and clients should be looking for partners with a demanding environment while simultaneously creating a positive internal community. This is unequivocally necessary for long-term and consistent delivery of superior results.

I want to convey what you should expect and what members deserve when working with any employee benefits service provider. This position has put me behind the curtain of different vendors, and what I’ve seen ranges from scary to amazing on what is happening. Lots of small players talking a big game without resources and lots of big players who don’t have the passion or the quality control to know what you will get.

It’s inevitable, right, that’s just this business, and that’s how it’s always been, so nothing can be done. Yes, there will always be some ignorance and unsubstantiated exuberance over an underserving company or program. If you are staking your reputation on a vendor, you have to do some digging. Consultants must rely on more than just the friendliest face at a conference who is always engaging. If we want to know if a company can deliver on their promises, we need to look at it from the inside. Don’t just ask for metrics or get flipped over to what could even be a paid reference. Sales is painting the best-case scenario, so figure out questions to ask for when things aren’t going well. I don’t have it all figured out, but here are some ideas:

  • How many W-2 employees are on the phones taking calls?
  • What pieces of the business do you outsource?
  • Can I meet all your Account Managers, not just the one you are assigning to me? We need to understand bench strength.

The very best thing you can do is a site visit. It’s not infallible; many companies can put on a good show. You should expect to meet the rank and file and see their connection to the mission. You should expect the opportunity to observe customer service in their respective workspaces. Once you see it, you will recognize an environment where employees do their job with passion, not just because they are cashing a check. It is worth a $500 plane ticket to visit a vendor so you don’t lose your client or ensure the member in need will be properly cared for. I was at ClaimDOC headquarters a couple of months ago during a basketball tournament. Watching the spirit and togetherness of our 100+ staff made me realize that I don’t do our culture justice during presentations.

Omar Playing Basketball

Culture is not something quantifiable, but it’s a chemistry within the community of employees you can feel; open communication, genuine caring, peer accountability, cooperation, and a vibrant work dynamic. All of this creates employee satisfaction, which creates belief in the mission, which creates optimal productivity, and that all leads to delivering on promises made during the sales presentation. I shouldn’t complain, but it’s not easy to sell something intangible that is so meaningful. Sometimes I think ClaimDOC is like Tom Brady running a 40-yard dash at the NFL Combine. Knowledge, passion, effectiveness, and commitment without the wow factor from a meaningless flashy exterior.

This isn’t just about ClaimDOC, and it’s not just about comparing us to competitors. This is about all your vendor selections. Do you trust the carrier not to push back on every claim? Do you trust pre-cert to be fully staffed internally with nurses who will treat members well? Do you trust the TPA to answer the phones and accurately pay claims?

I just wrote a 3,800-employee group for this fall, and the opportunity didn’t come to me because I’m the best salesperson. It came because of the reputation our staff has built with deep dive audits and extraordinary member service. After being burned by poor reference based pricing delivery, they were directed to ClaimDOC. Once they landed on us, they had to decide on a TPA. I gave them a handful of options and explained the reality is the TPA business is not as easy as everyone assumes. There will be errors, and you must pick the one you feel most comfortable with and has the culture embedded to not just deliver a good sales story but step up when things get hard. They visited a smaller TPA and made their decision after being impressed with the operation, the people, and the leadership.

It doesn’t ensure perfection. However, the accountability created when you look at people doing the work in the eyes will matter. Digesting the care and the passion of the internal community at any vendor will give you the confidence to be a partner and work together to get plan sponsors what they deserve.