98% Improvement in CMS Compliance     |     90% Reduction in Error Rate     |     50% Increase in Report Delivery Levels    |    50% Enhancement in Adherence to Due Dates     |     60% Improvement in External Agency Collaboration     |     75% Rise in Data Validation     |     98% Improvement in CMS Compliance     |     90% Reduction in Error Rate     |     50% Increase in Report Delivery Levels    |    50% Enhancement in Adherence to Due Dates     |     60% Improvement in External Agency Collaboration     |     75% Rise in Data Validation     |     98% Improvement in CMS Compliance     |     90% Reduction in Error Rate     |     50% Increase in Report Delivery Levels    |    50% Enhancement in Adherence to Due Dates     |     60% Improvement in External Agency Collaboration     |     75% Rise in Data Validation     |     98% Improvement in CMS Compliance     |     90% Reduction in Error Rate     |     50% Increase in Report Delivery Levels    |    50% Enhancement in Adherence to Due Dates     |     60% Improvement in External Agency Collaboration     |     75% Rise in Data Validation     |     98% Improvement in CMS Compliance     |     90% Reduction in Error Rate     |     50% Increase in Report Delivery Levels    |    50% Enhancement in Adherence to Due Dates     |     60% Improvement in External Agency Collaboration     |     75% Rise in Data Validation     |     98% Improvement in CMS Compliance     |     90% Reduction in Error Rate     |     50% Increase in Report Delivery Levels    |    50% Enhancement in Adherence to Due Dates     |     60% Improvement in External Agency Collaboration     |     75% Rise in Data Validation     |    

“Newgen’s Appeals Solution has simplified our entire processes, improved accuracy, and strengthened compliance, helping us achieve new levels of efficiency.”

– Vice President of Member Services & Appeals, A Leading Health Plan

Built for Payers. Designed for Members

Leverage our Complaints, Appeals, & Grievances Suite to build trust with a member-first approach.

Efficient Case Management

Detect/flag duplicates to prevent fraud and speed up resolutions. Automate case allocation to optimize bandwidth and manage escalations. Ensure robust integration with document management capabilities for smoother workflows, improved accuracy, and faster claims.

Unified Information Capture and Processing

Consolidate data capture from multiple sources for efficiency. Fetch eligibility details of members and providers in one place. Leverage GenAI to extract critical data, classify records, and generate instant summaries for informed decision-making.

Automated Communications, Audit Documentation, and Packet Generation

Generate automated correspondences to ensure adherence to regulatory mandates. Compile case summaries with relevant data and artifacts. Create downloadable case packets for internal/external audits and CMS compliance.

360-degree Case Visibility, Decision Support, and Integration

Access a comprehensive dashboard to manage cases and get periodic updates. Leverage AI/ML to augment decision-making efficiency. Integrate clinical/MD reviews for accurate case assessment. Ensure robust integrations with external portals for smooth data exchange.

Efficient Case Management

Detect/flag duplicates to prevent fraud and speed up resolutions. Automate case allocation to optimize bandwidth and manage escalations. Ensure robust integration with document management capabilities for smoother workflows, improved accuracy, and faster claims.

Unified Information Capture and Processing

Consolidate data capture from multiple sources for efficiency. Fetch eligibility details of members and providers in one place. Leverage GenAI to extract critical data, classify records, and generate instant summaries for informed decision-making.

Automated Communications, Audit Documentation, and Packet Generation

Generate automated correspondences to ensure adherence to regulatory mandates. Compile case summaries with relevant data and artifacts. Create downloadable case packets for internal/external audits and CMS compliance.

360-degree Case Visibility, Decision Support, and Integration

Access a comprehensive dashboard to manage cases and get periodic updates. Leverage AI/ML to augment decision-making efficiency. Integrate clinical/MD reviews for accurate case assessment. Ensure robust integrations with external portals for smooth data exchange.

Learn What Newgen’s Appeals Solution Can Do for You

Explore Other Solutions for the Payer-Member Journey

Find Your Winning Strategy with Newgen

Schedule a Demo to See Newgen’s Payer-Member Solution in Action

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