Blogs

Insights for Optimized Healthcare Operations: Explore Our Blogs

February 21, 2024

Sagility Experts Weigh In: As-a-Service Solutions Drive Improvements for Payers

Healthcare organizations face tight budgets, a continued need to increase productivity, lower costs, enhance technology, and reinforce IT infrastructure all while continuing to improve the healthcare consumer experience. While building and implementing a strategy to holistically address each of these challenges may seem counterintuitive at first, using an as-a-Service process makes it possible to achieve […]

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By Titus Leo and Jason Besterfeldt

Senior Vice President Client Services and Senior Executive in Healthcare Revenue Cycle

January 30, 2024

Fiscal Health for Providers: Precision Cost Takeout in 3 Areas

By Titus Leo and Jason Besterfeldt As today’s hospital margins are increasingly in the red, and health systems are asked to do more with less, all eyes are on cost removal. According to a recent survey on healthcare outsourcing conducted by Black Book Market Research LLC, 90% of healthcare executives are exploring cost savings through […]

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December 20, 2023

Optimizing Operations and Improving the Provider Experience through End-to-end UM: Your questions, answered

UM and prior authorization, which is the most commonly practiced form of utilization management, are both highly regulated, and health plans can face high penalties and fines when they are out of compliance. The existing US nursing shortage is another factor exacerbating the pain for payers who struggle to render decisions in a timely manner. […]

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October 5, 2023

BPO, Supercharged: Business Process as a Service Drives Scale, Savings While Exponentially Enhancing Outcomes

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.

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July 5, 2023

4 ways to win with claims denials

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 […]

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Abhishek Danturti Sharma

Principal, Business Transformation, Sagility

March 25, 2023

Transformative AI to revamp prior authorizations

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 […]

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Reetha Menon and Abhishek Danturti Sharma

January 24, 2023

Three healthcare cloud myths, debunked

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 […]

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Zaffar Khan

AVP Transformation

September 23, 2022

Sagility: Voice of the Consumer

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, […]

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Reetha Menon and Abhishek Danturti Sharma

April 20, 2022

How Back-Office Accelerators are Steering Optimized Experience

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.

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Reetha Menon and Abishek Danturti Sharma

February 17, 2022

Sagility Future Digital Series: Front-Office Accelerators

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 […]

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Sagility

January 20, 2022

3 Fresh Ideas for Winning the Competition for Healthcare Talent

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 […]

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Subrahamanyam Mantha

Vice President, Payment Integrity, Sagility

December 16, 2021

3 Payment Integrity Imperatives in Post-Pandemic Healthcare

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.

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Ramesh Murugesan

Associate Vice President, Business Excellence and Data Science, Sagility

December 8, 2021

Building a Successful Data Culture in the Post-Pandemic Healthcare Reality

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.

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Lokesh Anbalagan

Associate Vice President and Head of Medical Coding Practice

September 16, 2021

5 Provider Coding Myths, Debunked

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.

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Priya Sabharwal & Stacy Wisner

Associate Vice President, Sagility & Senior Director of the CRM Center of Excellence, Sagility

August 4, 2021

Health Plan Guidance: 3 Essentials for No-Surprises Act Compliance

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

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Abhishek Danturti Sharma

Assistant General Manager - Lead Data Scientist, Business Transformation

July 26, 2021

The Human Side of Healthcare 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.

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June 1, 2021

Three Ways Healthcare Engagement Models Differ from Other Industries

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.

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February 1, 2021

Preventing and Appealing Clinical Denials with Analytics, Automation, and AI

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.

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For Better RCM, Prioritize People and Track with Technology

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.

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November 23, 2020

Member Experience: Never a Better Time for Digital Enablement

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.

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September 30, 2020

Seamless Customer Experience Begins with Enhanced Direct Enrollment

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.

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September 22, 2020

Precision Utilization Management: Meeting Patients Where They Are

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.

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August 5, 2020

Bridging Provider-Payer Gaps with Today’s Technology

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.

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Dan Schulte

Sagility Provider Revenue Cycle Practice Leader

July 10, 2020

4 Ways that Healthcare Systems can Manage Denied Claims

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.

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Srikanth Lakshminarayanan

Vice President, Center of Excellence for Healthcare Engagement Services (HES)

June 19, 2020

Healthcare Customer Engagement: Charting an Empathetic Experience

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.

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January 21, 2020

Social Determinants of Health: Insights from our Experts

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.

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