Business Process as a Service
Delivering entire business processes with technology that transforms the healthcare process experience and improves efficiency
Business Processes Delivered on the Cloud
At Sagility, our deep healthcare industry domain knowledge and process expertise is being put to use to develop end-to-end services that are built upon cloud technologies. These efforts are resulting in comprehensive services that are carved out for delivery on the cloud with minimal capital expenditure. With an eye to transformation and greater business impact, these solutions assume a wholistic view of the business scenarios and the need for integration to the rest of the client enterprise. A fully bundled service offering results in faster time to implement and achieving business impact.
Building Blocks to our BPaaS Solutions
Claims BPaaS
Our Claims BPaaS solution combines operations and technology that seamlessly integrates with client retained platforms and processes. We take a holistic approach to facilitate all aspects of Claims processing, providing a robust solution that enables:
- Streamlined claims processing – Our integrated service enhances efficiency with end-to-end claims processing capability.
- Hybrid delivery model – Pairing Sagility and client platforms provides a comprehensive, effective claims management solution that strikes a perfect balance between cost and value.
- Expanded functionalities – Additional services such as EDI Management and DMS are included. This in combination with optional payment integrity services opens up additional opportunities for improving claims efficiency.
- Partnership with industry leaders – We collaborate with leading Claims Administration and G&A software providers for a more robust and extended service offering.
Contact Center as a Service
Sagility offers a comprehensive solution for all call center needs. Our solution is built on the latest cloud-based telephony solutions and has pre-integrated solutions for AI-driven speech analytics, call deflection, agent scripting and quality management, and task automation within a single turnkey solution. This integrated platform amplifies the effectiveness of our highly-trained and healthcare-focused agents to meet all of your call center needs from Members, Providers, and Brokers.
Aging in Place
Sagility’s Aging in Place solutions are built upon our data hub architecture that collects information about a member from the payer, our service partners, and from the member themselves via interactions with our self-service portals or by connecting digital health monitoring devices. All information collected about a member adds to their unique profile and is used to generate personalized interactions through our portal and agents, as well as driving additional insights through our proprietary, dynamic analytics models. From the lowest to the highest risk member, our program personalizes their journey to remain healthy and safe in their homes.
Utilization Management
Sagility’s end-to-end solution for utilization management blends the latest in AI-driven techniques to provide a streamlined experience for the provider that allows for faster and more intelligent authorization processing. Authorization requests from any inbound channel (fax, email, EDI, or through our Provider portal) are processed through our intake process utilizing our proprietary authorization rulesets, your custom rulesets, and industry standard rulesets that can provide instant feedback to the provider, query them for additional information, or automatically request medical record evidence for the authorization. When those medical records are provided, they are automatically scanned by our NLP engine to highlight the relevant sections for the request being reviewed and reviewed by our nursing staff to reduce the burden on your clinical decision-makers. Once the intake process and review is complete, the case is automatically uploaded into your case management system (e.g., TruCare).
Provider Data Management and Credentialing
Sagility’s Provider Engagement solutions exist to help our clients meet the stringent new rules around the quality of their provider data. Our core Provider Forward solution allows our provider outreach agents to most efficiently collect the necessary data and enables additional complex capabilities like Provider credentialing and recredentialing. Our data hub-based solution creates a profile of each provider and tracks all of the interactions with that provider, their admin, and associated health systems across their interactions with our agents, our self-service portal, and other service providers. These profiles are used to ensure each provider is contacted in the most effective way and reduces the amount of outreach necessary to keep your directories up to date. Complex tasks like credentialing are built on top of an automated primary source validation (PSV) process that reduces the effort in completing a credentialing cycle from days to hours.
Speak with an expert to hear more
Connect with a Sagility expert today. Let’s explore innovative solutions tailored to your organization’s unique needs.
