Health plans have long understood the benefits of business process outsourcing (BPO). Faced with the heightened prioritization of customer needs, experience, and value stream impact, these health organizations are now looking to drive more positive business outcomes through service providers on an “As a Service” model rather than the traditional transactional models.
Facing both revenue and expense issues and exasperated by clinician shortages, hospitals are increasingly noting denials in the danger zone. “Danger zone” translation: Denials are increasingly higher than 10%, costing significant dollars in lost or delayed reimbursements—as well as more overhead for rework and resubmitting claims. A recent Crowe RCA benchmarking analysis provided the industry-wide […]
TRANSFORMATIVE AI TO REVAMP PRIOR AUTHORIZATIONS Tech enablement drives lower costs, lessened provider abrasion Health plans are unnecessarily burdened by administrative tasks such as prior authorization—a costly bottleneck to optimized care and operational outcomes. Recent American Hospital Association (AHA) research states that that 95% of providers spend increasing time seeking prior authorization approval. An astounding […]
Three healthcare cloud myths, debunked With ever-increasing, rigid regulations, and the most sensitive personal data of any industry, healthcare has walked slowly toward technology and transformation. And this is particularly true when it comes to the cloud. COVID-19 may have been the catalyst in forcing healthcare’s hand, with the industry required to quickly implement employee […]
Modernized, AI-enabled VoC to Meet Today’s CX Today’s healthcare members will act on failure to meet their expectations, according to recent Forrester research, with 34% of dissatisfied customers changing health plans. Equipped with this knowledge, health insurance plans can renew their focus on measurement of Voice of the Customer survey feedback to improve customer engagement, […]
The digital age has shed new light on the need for interoperability for healthcare, as backed by recent imperatives such as the Centers for Medicare & Medicaid Services (CMS) Fast Healthcare Interoperability Resources (FHIR) or the Provider Gold Card standards.
Bridging journey gaps through the digital front door In terms of optimized healthcare experience delivery, the digital front door has been less an entry point and more an essential touchpoint of the complete healthcare member journey that connects experience and care. While health insurance has been flagged for low customer satisfaction in the past, that’s […]
The past two years have brought a perfect storm of challenges for healthcare providers. COVID-19 has had a profound impact on healthcare overall—resulting in one of the all-time worst financial crises for providers. And the talent supply and demand gap has only widened as a result of compounding factors like the Great Resignation, the remote […]
Sagility leaders identify three main factors behind heightened payment integrity (PI) pressures post-pandemic (i.e., volumes and resources, regulation changes, telehealth) and explain how PI solution experts can help payers reduce those pressures.
Sagility’s Ramesh Murugesan describes challenges in data science deployments, how to build a healthcare data culture, and the importance of the democratization of data and analytics.
Over the past 18 months, healthcare providers have grappled with historic cost and care challenges. The COVID-19 pandemic has increasingly forced providers to assess new areas of transformation to unlock operational value and cost efficiencies.
In recent years, the healthcare industry has increasingly been paying attention to the error rates in health plan directories. Undependable directories create poor member experience
Over the past 18 months, healthcare providers have grappled with historic cost and care challenges. The COVID-19 pandemic has increasingly forced providers to assess new areas of transformation to unlock operational value and cost efficiencies.
Health plans have long understood the benefits of business process outsourcing (BPO). Faced with the heightened prioritization of customer needs, experience, and value stream impact, these health organizations are now looking to drive more positive business outcomes through service providers on an “As a Service” model rather than the traditional transactional models.
Health plans have long understood the benefits of business process outsourcing (BPO). Faced with the heightened prioritization of customer needs, experience, and value stream impact, these health organizations are now looking to drive more positive business outcomes through service providers on an “As a Service” model rather than the traditional transactional models.
Health plans have long understood the benefits of business process outsourcing (BPO). Faced with the heightened prioritization of customer needs, experience, and value stream impact, these health organizations are now looking to drive more positive business outcomes through service providers on an “As a Service” model rather than the traditional transactional models.
Health plans have long understood the benefits of business process outsourcing (BPO). Faced with the heightened prioritization of customer needs, experience, and value stream impact, these health organizations are now looking to drive more positive business outcomes through service providers on an “As a Service” model rather than the traditional transactional models.
Health plans have long understood the benefits of business process outsourcing (BPO). Faced with the heightened prioritization of customer needs, experience, and value stream impact, these health organizations are now looking to drive more positive business outcomes through service providers on an “As a Service” model rather than the traditional transactional models.
Providers view prior authorization as a manual, burdensome, and laborious process, mostly because of process missteps such as lack of clinical data integration, inconsistency in data exchange standards, and differing policies among payers.
Across the world, today’s healthcare organizations are sharing one critical challenge: the rising costs associated with improvement in quality care. The underlying mandate is that all stakeholders must keep a sharp focus on making healthcare more effective, efficient, and affordable. To meet this new demand, both payers and providers have made adjustments to service delivery—and technology is increasingly playing a pivotal role.
Provider healthcare technology has progressed rapidly to advance clinical care. Despite the leaps forward in provider technology, innovation has been comparatively slow for most providers’ financial processes.
The recent COVID-19 surge has exposed CX teams to an all-new type of issue, one which no bot or digital channel has ever dealt with, to date. What’s needed is a fresh approach to empathy-based engagement as part of healthcare customer experience.
Health plans have long understood the benefits of business process outsourcing (BPO). Faced with the heightened prioritization of customer needs, experience, and value stream impact, these health organizations are now looking to drive more positive business outcomes through service providers on an “As a Service” model rather than the traditional transactional models.
