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Improving Experience with Projected Cost Savings of $1.5 Million
Claims automation saves $1.5m for leading payer
US hospital system achieves 80+% overturn of denials
Achieving preferred provider NPS while seasonal scaling at 250+%
Smita Nair Jain
Srinivasan SD
Sohail Djariri
Ramesh Gopalan
Mohit Saxena
Madan Moudgal
Dan Bailey
Anand Biradar
Amitabh Singh
Employing Clinical Process Outsourcing to Drive Down Medical Costs For a Major Payer
Leading Physician Network Provider Improved Data Accuracy with PDM, Saving Nearly $1 Million
From-scratch Provider Data Stewardship Earns Wins in Quality, Compliance, and Cost-containment
Dental Plan Cognitive Review Innovation: Wins Across Efficiencies, Accuracy, and Time
Achieving 400% Scale to Support Group and IFP Business
Achieving Significant Scale to Support HealthRules Payer Migration
Labs and Durable Medical Equipment Support
Patient Engagement
Improving Cash Flow Collections by More than $30 Million Annually
Achieving Breakthrough Member NPS and CSAT for a Global Healthcare Payer
Achieving A/R Reduction for Nearly 90% Resolution
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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 […]
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Press Release: Sagility LLC Acquires Devlin Consulting, Inc.
DENVER, April 25, 2023 08:00 AM Eastern Daylight Time – (BUSINESS WIRE) – Sagility LLC, a leading provider of technology-enabled business process management (BPM) services, announced today their acquisition of […]
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 […]
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 […]
Challengers of the Status Quo In Billing and Claims — More Accurate and Fairer Payment
This coverage demonstrates Sagility’s thought leadership on the potential for dramatic change in an area that’s long been an issue for health insurance plans. Article originally published by Managed Healthcare […]
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 […]
Sagility: Voice of the Consumer
Modernized, AI-enabled VoC to Meet Today’s Healthcare interactions Today’s healthcare members will act on failure to meet their expectations, according to recent Forrester research, with 34% of dissatisfied customers changing […]
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.
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 […]
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 […]
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.
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.
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.
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
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.