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Design Thinking as Disruption Enabler in Healthcare

By Krithika Srivats, Vice President, Sagility Practice Office  This article was published in HIT Consultant. According to the American Hospital Association, an overwhelming majority of hospital executives consider technological innovation a centerpiece of their long-term organizational goals, particularly as it pertains to solving complex problems and meeting the needs of consumers. However, if you […]

Machine Learning Enables Payment Integrity to Drive Maximum Claims Cost Savings

By Anju Sah, DGM Operations, Sagility Today’s payers are burdened by the complex and traditionally manual and labor-intense task of finding aberrations in services billed that could be indicative of fraud, waste, and abuse. Enter payment integrity as opportunity. In the past, healthcare organizations have leaned heavily on adjudicators to identify fraud. However, this […]

Scaling, Sustaining Automation Success: Insights from Our Automation Experts

Earlier this year, Sagility released a white paper on this year’s top 10 trends in customer service. In this blog, we dissect CX Trend No. 9, Robotic process automation (RPA), transforms both the back office and front office, highlighting tools and tactics designed to drive the right answer, fast, for your customers—to ultimately result in a higher […]

4 Elements of Effective PHM Campaigns

Dr. Virginia Gurley, Senior Vice President and Chief Medical Officer at Sagility, an Sagility company To successfully navigate the volume-to-value marketplace shift, today’s healthcare organizations are sharpening focus on closing care gaps and reducing the negative health impact of social risk factors. Some reports show that up to 80% of payers are integrating social […]

3 Ways Health Plans Can Improve Risk Score Accuracy

By Krithika Srivats, Vice President, Sagility Practice Office and Krishna Dharani Daliparthi,  Associate VP, HC The transition to value-based care has shed light on areas of critical opportunity for financial and quality improvement, and risk adjustment is at the top of the list for payers. From physician abrasion to compliance hurdles, there are potential […]

How Artificial Intelligence Can Transform Payment Integrity

By Krithika Srivats, Vice President, Sagility Practice Office This article was published in Becker’s  Hospital Review. In 2013, the actress Angelina Jolie published an opinion column in the New York Times that described her decision to undergo a preventive mastectomy after testing positive for the BRCA gene, a mutation that can lead to breast […]

Nurse Triage Lines: 3.0. Podcast with Sagility

By Krithika Srivats, Vice President, Sagility Practice Office Nurse triage is at the center of providing the right service, at the right time, by the right level of providers. The ROI can be significant for payers and providers, in terms of patient and member satisfaction and reducing costs of care for services not delivered […]

How to Win with Denied Claims

By Dan Schulte, Senior Vice President, Sagility For many hospitals and health systems, denied claims are just the price of doing business. You wouldn’t be wrong to detect a note of fatalism in that sentence. According to the Becker’s Hospital CFO Report, denied claims in 2016 had an estimated value of $262 billion. Digging […]

The 7 Qualities of a Great Healthcare BPO Partner

By Anand Natampalli, Sagility SVP, Sales and Business Development, Healthcare Business Process Outsourcing (BPO) used to be a strategy organizations in many industries implemented primarily as a way to cut costs. Today, lift and shift is no longer the primary driver of BPO in healthcare. Instead, it’s the overwhelming need to keep up with a […]

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