Fortune 500 Healthcare Payer Automates Appeals & Grievances Process with Newgen
Download this case study to learn how the Health Plan overcame Appeals and Grievances challenges using Newgen Solutions.
The organization wanted to re-engineer and automate the appeals and grievance handling process. Following are some of their key business concerns:
- Highly manual processes and compliance relies on manual monitoring to perform work that is audited by regulators
- Multiple lines of business (Claims/Pharmacy/Core Appeals/Grievance) have to comply with the mandated turnaround time (TAT)
- Process often involves moving papers between groups, location and resource with scanning while electronic storage occurs towards the end of the process
- Anytime anywhere tracking of appeals /grievance by Appellants
- Automatic exception handling and alert messages about the cases with expired due dates