Solutions for Health Insurers

Automated solutions simplify complex Appeals and Grievances processes and Prior Authorizations enhancing customer satisfaction while maintaining compliance
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January 27, 2022

Episode 18: Tech Trends & Predictions 2022

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Episode 17: Low Code Platforms – Game Changer or Hype

Paula Kielty, New Business & Policy Manager, CUMIS discusses low-code platforms

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Appeals and Grievances

When complex, knowledge-based operations rely on manual, paper-based processes, the results are low productivity and a diminishing bottom line. Excellarate’s solutions for Appeals and Grievances solutions help to transform operations.

Faster, Smarter Investigations

Case information is captured, cataloged, and stored in a central location, then automatically prioritized and distributed

Increased Bottom Line

Automated processes reduce incidence of error, maximize resources, and speed up case resolution, reducing administrative costs and maximizing revenue potential

Simplified Compliance

Confidently comply with contractual obligations as well as state, federal, NCQA, and group regulations using case tracking, reporting, and comprehensive audit trails

Higher Customer Satisfaction and Retention

Automated processes and robust digital cataloging system enable faster case resolution and promote rapid member access to care and claim payments

Increased Employee Productivity

All relevant case information is easily stored and accessed in a single location, which eliminates time lost searching for documents and simplifies decision-making

Greater Agility

Automated functionality locates and returns information quickly, enabling faster response times to information requests from customers, legal discovery, and regulatory requests

Prior Authorizations

Optimal decision making for authorization requests requires speed and accuracy, but reliance on paper-based processes works against both. For the customer awaiting a specialist or medical procedure, a delay in authorization can be a major source of frustration.

Excellarate’s Prior Authorization solution enables a streamlined authorization processing that eliminates the paper and drives smarter decision-making, better customer service, and higher productivity.

Find Out How
Automates processes and workflows, improving accuracy while speeding up the overall process
Simplifies decision-making by consolidating all relevant data, rules, and history in a single location
Distributes work to the right staff, providing a collaborative workbench
Leverages and enhances the usability of existing line-of-business systems
Promotes quality and consistency using automation and integrated rules
Satisfies all prior authorization requirements with specifically-designed user interfaces

Acing Insurance’s Digital Transformation Initiative

Four digital transformation success stories that demonstrate tangible business outcomes.

Find out how four large insurance providers in the US accrued real cost savings, account expansion and business value through their digital transformation initiatives.

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