By eliminating e-mail, Well being Plans resolve Complaints, Appeals and Grievances sooner


Encourage Improvements, a member of the Managed Care Useful resource Alliance and an InsureTech consulting and software program agency right now introduced its ongoing dedication to assist Well being Plans remodel their Complaints, Appeals and Grievances operations by launching CAG Outreach TM, a safe software program resolution that replaces e-mail for inner and exterior correspondences for Appeals and Grievances case decision.

“Safe on-line Tasking capabilities have at all times been an integral a part of our Case Administration software program. Now we’re making this distinctive functionality a stand-alone choice referred to as CAG Outreach TM Well being Plans will have the ability to make the most of our resolution it doesn’t matter what system they presently use as their core Appeals and Grievances case administration system,” stated Tyson Slater, Director at Encourage Improvements.

CAG Outreach TM  is a HITRUST licensed cloud-based software program as a service based mostly on the newest micro-services expertise and strong integration framework to be securely and rapidly built-in with a well being plan’s present enterprise techniques. With CAG Outreach Plans can carry out outreach electronically on-line together with: 

  • Sending Requests for Info and investigation of Member Points
  • Looking for Scientific evaluations of preliminary selections or different particulars on preliminary denials
  • Requesting Effectuation of Attraction Choices

Confirmed options embrace: 

  • Fast and Safe Activity Creation with pre-population of related case knowledge to keep away from rekeying knowledge
  • E-mail like simplicity for each Activity Assignor and Activity Recipient to hurry adoption
  • Particular person and/or group activity assignments
  • Requests for clarification and time extensions by recipients
  • Setting of deadlines and alerts for monitoring SLAs
  • Attachment of paperwork
  • Audited real-time dialogue threads for speedy collaboration
  • Activity Standing and Reporting

“Appeals and Grievances departments inside a Well being Plan rely closely on different departments and delegate organizations to rapidly resolve grievance and attraction instances. Utilizing e-mail is a problem as a result of it can’t be tracked or reported on. The tasking functionality offered by CAG Outreach permits our shoppers to trace requests for data from different departments, suppliers or companions via a trackable and reportable system,” stated Daniele Chenal Director of Healthcare at Encourage Improvements. “This considerably hastens the decision course of and holds everybody accountable to timelines.” she continued.

You may study extra about CAG Outreach TM and our whole suite of Complaints, Appeals and Grievances software program options by requesting a product demonstration at: https://cag-cloud.youcanbook.me or studying a Complaints, Appeals and Grievances Workflow Automation Case Research.

Encourage Improvements presently works with a number of the world’s most profitable healthcare and insurance coverage firms to assist them obtain their transformational goals. For extra data, go to Encourage Improvements at www.InspireInnovations.com.

Supply: Encourage Improvements