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Compliance, Customer Service and the Healthcare Industry

Between 1995 and 2015, employer-sponsored health insurance premiums increased by 203 percent – outpacing inflation and worker’s earnings, according to the Journal of American Medical Association. And this statistic represents one of many reasons why the healthcare industry could benefit from streamlining healthcare processes.

Multiple sectors of the healthcare industry want to embrace the challenge of innovating in the highly regulated healthcare industry, but especially pharmaceutical and health insurance companies. Changes in regulation and growing cost demands require significant documentation from pharmaceuticals and health insurance companies alike.

A growing demand to reduce costs and inefficiencies within the industry makes document generation an appealing option for healthcare companies. In this blog post, I’ll dive into the challenges and opportunities for pharmaceutical and health insurances companies, though many of these are echoed throughout the healthcare industry.

You can automate many documents with Nintex Drawloop® Document Generation.

The Challenges of Pharmaceutical Companies

Within the pharmaceutical industry, consumers are becoming choosier about medicines they buy due to escalating out-of-pocket-costs and drug prices. Both consumers, doctors, and insurers are requesting documentation to help them make informed choices about whether or not to pay for certain medicines.

According to an article in the International Business Times,  an estimated “four-fifths of U.S. health insurers require pharmaceutical companies to demonstrate cost savings or show clear benefits to patients to cover a new medicine.”

This puts pressure on pharmaceutical companies in the healthcare industry to demonstrate that expensive medications are worth the premium by providing the appropriate informational material.

Armed with a massive amount of data, the challenge for most pharmaceutical companies is how to pull, present and deliver the information to doctors and consumers succinctly and efficiently. While most pharmaceutical companies have adopted systems like the Salesforce Service Cloud to accurately manage and track customer inquiries, responding to these requests expediently continues to be a challenge. What if there were a way to automate the process?

What Documents Can Pharmaceutical Companies Automate?

With automated document generation in the Salesforce Service Cloud, pharmaceutical companies can easily match and meet customer demand for medical response letters and other important data/documents.

The benefits are immediate and impactful:

  • Cut customer response times exponentially
  • Control document content and how service reps communicate with customers
  • Dramatically reduce compliance risks associated with manual processes

Here are two pharmaceutical scenarios that could benefit from a document generation solution:

Medical Response Letters:

 Salesforce Service Cloud users can access these documents. However, before sending them to customers, a customer service rep must craft an email, attach multiple documents and then manually send out one or multiple emails. This is extremely time-consuming and leaves the pharmaceutical company vulnerable to compliance issues.

But with a document generation solution, companies can easily and painlessly generate needed documents. Since all documents are pre-loaded into Salesforce, a customer service rep simply queries the document database based on subject, description or keywords.

Once Nintex Drawloop® Document Generation identifies the documents, it merges them with a pre-approved letter (which can also be customized to each request), packages them and sends them as a single email attachment. Utilizing document generation with Salesforce Service Cloud streamlines the process to save time, while ensuring compliancy.

Event Audits:

Many pharmaceutical companies that either operate or are based in Europe are now required to audit any event held with doctors or other customers. It includes tracking everything from attendees and expenses to contracts and communications.

With an automated document generation process in Salesforce, pharmaceutical companies can now automate the process of both inviting customers and tracking the event. For example, if there’s a doctor in another country whom you want to invite, you’d simply query your document template database in Salesforce for the applicable language invite and then with the click of a button, send it out.  This would then also automatically update the doctor’s record. Once the event is over, you can aggregate all of the data in Salesforce as proof of compliance.

For pharmaceutical companies, an automated document generation process in Salesforce Service Cloud significantly speeds the process of providing complete information to consumers and doctors.

The Challenges of Health Insurance Providers

Health insurance providers are challenged each year to onboard thousands of new corporate clients.  Volume alone makes this a complex problem, but to execute the multiple documents required consumes a massive amount of time.

Many multi-billion dollar health insurance companies have undertaken a complex and successful deployment of Salesforce, but their salespeople sometimes still must manually extract the data and rekey it into their documents. In addition, many documents aren’t in Salesforce but are located in legacy or another third party system, which requires that the sales representative embark on a virtual “document hunt” to aggregate everything for a proposal.

By implementing document generation within Salesforce, you can eliminate the need to touch data twice and hunt down documents, and immediately impact your organization’s productivity.

This means sales representatives can do the following:

  • Spend more time selling and less time on administrative tasks
  • Generate sales documents in minutes, not hours
  • Customize proposals based on Salesforce or third party data
  • Improve the customer experience
  • Control and maintain brand standards
  • Integrate with eSign for multiple electronic approvals and signatures

What Documents Can Health Insurance Providers Automate?

With automated document generation, health insurance companies can more easily meet the high compliance requirements they face.

The benefits are immediate and impactful:

  • Generate proposals faster
  • Ensure that documents meet brand standards
  • Make renewals a seamless process

Here are just a few examples of how document generation can benefit insurance companies in the healthcare industry:

Customized Proposals:

With document generation in Salesforce, you can now create highly customizable proposals in minutes based on any business rule – state, type of customer, type of insurance and type of benefits. The business logic is built into the document template and automatically merges the appropriate data. Documents are then combined into a single package, no matter the type or size, and automatically sent to the corporate client as a single attachment.

Broker Sales Documents:

Health insurance providers often work with brokers or clients that pass the information onto prospects. Similar to sending a proposal directly to a corporate client, many health insurance providers utilize document generation to create a customized proposal package that a broker can then pass along to their client. The time to find, create and distribute the documents is drastically reduced, and all documents will meet the health insurance firm’s brand standards.

Annual Renewal or Business Certification Form :

Document generation allows health insurance providers to automatically send out renewal contracts to their corporate clients, as well as any required documentation like business certification forms. The process is automatic and doesn’t need to be manually managed.


For more information on Nintex Drawloop® Document Generation and how it can help companies in the healthcare industry, explore the videos and blog posts in the Nintex Drawloop® Community Forum.


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