For Payers

Provider network management

Deliver quality and cost-containment with Provider Forward innovation.

Today’s payers are increasingly looking for a cure for the critical and costly issue of inaccurate provider data. A recent HHS survey uncovered data errors in half of the doctor listings for Medicare plans. Inaccurate or poorly managed provider directories present significant challenges for payers, including: dissatisfied members, provider abrasion, administrative burden, and penalties.

Sagility’s Provider Forward features a 360-degree view of the provider journey and touchpoints at various contracting and maintenance processes. This solution integrates cost-effective people, process, and technology, including a purpose-built analytics/AI platform integrated with a CRM to manage end-to-end provider data.

Sagility’s platform improves the connect ratio based on historical successes, and a predictive model algorithm that prioritizes the queue to increase successful data collection.

Our Provider Forward, digital, and RPA solutions provide complete visibility of the end-to-end provider’s journey, while being compliant with CMS and state guidelines and millions of dollars saved in operating costs.

Our Solution

Benefits of our network management solutions include :

Reduction in costs of preparing directory files

Improvement in claims auto-adjudication rates

Improvement in operational efficiencies

Reduction in rates of pending claims

Fraud detection and immediate action

Avoidance of resource costs to support claims fallout and member service

Improvement in access to care and provider relationships

At Sagility, we believe in being transparent. Our technology platform is modelled in such a way that it provides a holistic view of a provider’s status across Network Management phases along with ongoing maintenance of provider demographic data.

Improve provider relationships with the right tools and workflow

Think your provider directories and credentialing workflow could be in better shape? You aren’t alone. A recent HHS survey uncovered data errors in half of the doctor listings for Medicare plans.

Fill out this form to gain access to our provider network management solution overview and see how it can work for your organization.

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