Navigating Disputes: Resolving a $10 Million Underpayment Challenge

Maintaining Margins in a Shifting Landscape: The Role of Payment Integrity Amidst Rising Medical Costs

Optimizing Claims Accuracy: Leveraging Subject Matter Experts to Address Payment Discrepancies in a Complex Managed Care Environment

Sagility’s GenAI Nurse Assist to Achieve Efficiencies, Faster Care

Achieving High AR Resolution

For this client, Sagility provided resolution for a segment/payer mix of AR GT 180+ days claims aged from date of service.

Claims Automation Aims to Save Payer Approximately $6 Million

Driving Breakthrough Member NPS and CSAT for a Global

Faced with the challenge of stricter CMS regulations and the need to improve member engagement, a global health insurer partnered with Sagility.

Improving Cash Flows by Advancing PI Recovery Collections of $15-20 Million Every Month

Sagility helped a leading payer significantly increase their ability to recoup overpayments, resulting in improved cash flow collections by more than $30 million annually.

Achieving Significant Scale to Support HealthRules Payer Migration

Aiding a longstanding health plan partner migrate their $3 million Medicare Advantage membership plans to HealthRules Payer seamlessly.

Provider Data Stewardship Earns Wins in Quality, Compliance, and Cost-containment

Sagility resolved data management and operational challenges for a rapidly growing health plan by implementing a comprehensive solution that optimized provider data management (PDM).

Frailty Resilience in Action: Smart Step Cuts Claims by 18%

18% Claims Reduction After Implementing a Frailty Care Management Program

Duals Plan Saves $51M with Risk Stratification and Care Management Advancements

D-SNP Saves $11M in Part B Drug Spend with Improved Utilization

How a D-SNP Cut $70M in PCA Spend While Improving Member Outcomes

Mitigating Overutilization to Reduce a D-SNP Medical Spend by $145M

How Sagility Supported Transforming a Global Health Plan

15+ Year Tenure with U.S. Health Plan: Scaling Care and Cutting Costs

Sagility Reduces Interest, Penalties by 30% for Leading Blues Plan

Corrected Claims RPA Saves Leading Blues Plan $1M