Smarter Quality Assurance for Healthcare Payers – Reduce Errors, Improve Compliance, and Save Time

As payer organizations gear up for one of the most document-intensive periods of the year—enrollment—rising compliance demands, and tight turnaround windows often cause Quality Assurance (QA) processes to become bottlenecks. In this blog, we’ll explore smarter, more scalable approaches to document QA across all lines of business. 

A Real-World Challenge: Manual QA at Scale

Consider a large regional health plan entering Q3. They’re simultaneously juggling Medicare Annual Notice of Changes (ANOC) updates, Affordable Care Act (ACA) Plan changes, and Large Group Summary of Benefits and Coverage (SBC) finalizations. Their document review cycles involve multiple stakeholders and constant toggling between document versions, tracked changes, and regulatory references. This story isn’t unique. Whether preparing plan materials for Medicare Advantage, processing, or finalizing employer-sponsored Group health documents, QA is often the most time-consuming phase in the document lifecycle for health plans across all lines of business. Compliance, product, and operations stakeholders must collaborate to ensure that plan changes are correctly reflected, tracked, and verified. But manual processes make it difficult to trace what changed, when, and why—and nearly impossible to maintain version-level accuracy across teams.

A Precise Tool for Version-Level QA

Most health plans still rely on outdated QA methods—PDF markups, tracked Word docs, and email-based review cycles. Whether it’s a CMS-mandated ANOC or an ACA Summary of Benefits, these workflows are time-intensive and error-prone. Even when managing dozens or hundreds of documents, reviewers often need to work version-by-version. In such cases, the ability to navigate two versions of a document side by side can help avoid confusion, errors, and repetitive toggling. That’s where Side-by-Side Comparison comes in.

What Side-by-Side Comparison Really Does

Simplify Healthcare’s Side-by-Side Comparison, part of the Simplify Docs™ platform, is designed to solve this problem across all business lines. Whether used as a standalone tool or integrated within Benefits1™, it brings consistency, speed, and auditability to every review cycle. Key features include:

• Synchronized Scrolling: Stay contextually aligned across documents.
• Interactive Change List: Click through content and style differences.
• Visual Style Detection: Instantly spot font, size, and formatting edits.

How It Helps Across Lines of Business

• Medicare Advantage: Streamlines ANOC/EOC updates with audit-ready comparisons that reduce submission errors and back-and-forth during AEP.
• ACA (Individual and Small Group): Speeds up SBC and plan comparison reviews while ensuring CMS compliance and reducing manual tracking.
• Large Group / Employer Plans: Helps manage high-volume benefit guides and open enrollment collateral, improving alignment with broker and HR timelines.

Real Results from Real Payers

Health plans working with us for document management have reported significant operational gains: one payer reduced production timelines by 33% and shortened review cycles by 6 weeks, another achieved a 50% acceleration in SBC generation with seamless transfer to centralized storage, and multiple Medicare Advantage organizations realized 50% faster prep with 100% on-time CMS submissions. These aren’t just time savings—they reflect stronger compliance, fewer manual errors, and greater collaboration across benefit, product, and compliance teams.

What’s Next

Curious how your team could benefit from smarter document QA? We’d love to share what we’ve learned. Reach out to us at letstalk@simplifydocs.ai. Stay tuned for our next blog, exploring how collaborative QA workflows create speed and clarity across product, compliance, and content teams.