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Appeals and Grievances

Simplifying Appeals and Grievances processes with tailored solutions to satisfy Compliance Regulations

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May 1 - 3, 2023

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When complex, knowledge-based operations rely on manual, paper-based processes, the results are low productivity and a diminishing bottom line.

Excellarate Complaints, Appeals and Grievances solutions help to transform operations that lead to,

  • Faster, smarter investigations and resolutions
  • Increased revenues
  • Lower costs
  • Improved customer satisfaction and retention
  • Higher productivity
  • Greater agility

Excellarate’s tailored Complaint, Appeal and Grievance solutions can:

  • Increase productivity and decision-making as all the relevant information is consolidated in a single view. Drive compliance with state, federal, NCQA, and group guidelines
  • Automatically distribute and prioritize each new complaint or appeal. Capture, catalog, and store all case-related information and documents
  • Track completed and outstanding cases with comprehensive audit trails
  • Automatically match requested information responses for pending cases to the right case file, reactivate the case and notify personnel of the updated status
  • Promote rapid member access to care and claim payments
  • Confidently comply with contractual and regulatory obligations
  • Automatically print the case file for legal discovery or regulatory requests

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“Excellarate brings a good mix of results-oriented industry experts together with offshore staffing to focus on a business problem. The end result being able to quickly deliver results in a cost-effective way.”

Jonathan GelhausChief Information Officer, Time Investment

“They seamlessly integrate with our team. We started seeing results within the first sprint. And due to the team's responsiveness, we were able to get our product to the sales cycle within 7 months.”

Jim NalleyWHZRT

“The team ramps up fast, is technically competent and therefore understands complex product requirements faster. With them, Tangoe has reduced cost by 2:1.”

Mike WatsonTangoe Wireless

“They are different because of the quality of their leadership, efficient team and clearly set methodologies. Studer gets high level of confidence from them along with significant cost advantage of almost 50%.”

Wayne HydeStuder Group

“The team is undoubtedly the 3rd generation of engineers, experts in agile programming and mobile technologies, who focus on processes and timelines, but never compromise on Quality. They have played a vital role in our scaling up and was a perfect partner in terms of cost, efficiency, and schedules.”

Herman SpencerQuickoffice

“They make the time zone differences work FOR the customer, enabling a positive experience for us. Seeing is believing, so we decided to give it a shot and the project was very successful.”

Ron WatsonCentric Software

“Partnering with them has helped ExamSoft considerably on reducing cost and has given the advantage of 24x7 development cycles.”

Mark HaneyExamSoft

“Their agile processes and daily scrums were very valuable, made communication and time zone issues work out successfully.”

Ed HerreraPDX, Inc

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