Healthcare Appeals and Grievances Solution
Automate appeals and grievances processing and adhere to applicable CMS and ACA timelines.
Cases are routed to the appropriate end user who can perform the task and automatically escalated when delays occur.
Capturing relevant case information during intake procedures ensures that critical information is available when needed.
All of the generated correspondence and other files and dcouments can be stored securely in a centralized repository and available for viewing and sharing as needed.
Escalation of delayed processing ensures timeliness of processing within specified timeframes.
Reduction in operational costs by eliminating manual process steps and paper-related costs.
Increased compliance by providing traceable, end to end audit trail of all process steps and transactions.
Improved efficiency by reducing time needed to process appeals by automating and streamlining workflow processing.
All actions are logged by the system and made available for auditing and reporting purposes.
Transform the customer experience by engaging them with personalized communications.
Faster response time for providers and members leading to greater satisfaction.
The Healthcare Appeals and Grievances Solution can be configured to meet your Appeals and Grievances input information needs.
The Healthcare Appeals and Grievances Solution can be configured to meet your Appeals and Grievances output needs, such as email notifications and correspondence.