Case Study: Fortune 500 Healthcare Payer Automates Appeals & Grievances Process with Newgen

CASE STUDY

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
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