Product enhancement means
adding some benefits to existing health plans. Different insurance companies
offer different types of health plans. As a matter of fact, health plan is the
marketing name. At the root of every health plan, there is a product and it is
known by its Product Id. Benefits including terms and conditions of the health
plans are tagged to this product id.
In
Facets, there are different application groups
to manage the product ids and add benefits as well restrictions to these product ids. The application groups are Dental Plan application group, FSA Plan application
group , ITS Plan application
group, Medical Plan application group and Vision Plan application group. Under each application group, their are different applications. Developers and Configuration analysts will use specific application or database table to perform specific task.
In order to meet regulatory requirements
and sometimes for their own reasons, insurance companies need to enhance their products.
For example, Insurance companies are required to implement USPSTF Grade A &
B recommendations as part of regulatory requirements. On the other hand, some
insurance companies need to increase copayment and deductible amount in their
existing products. Sometimes they also put cap on some benefits. So, in order to perform these types of changes, insurance
companies start special projects known as Product Enhancement projects.
Insurance companies are implementing following
major product enhancements as part of their 2017 regulatory requirements:
1. Adult Tuberculosis
(USPSTF Grade B Recommendation)
2.
Colorectal Cancer Screenings Mandate (USPSTF
Grade A Recommendation)
3.
HTN
Screening and Home Monitoring Mandate (USPSTF Grade A Recommendation)
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