Healthcare engagement models differ from other industries in three ways: compliance needs, customer types, and org structures. A BPO can assist in minimizing differences to truly put customers first.
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Proper revenue cycle management (RCM) involves careful documentation of the entire patient journey. Once captured by a proficient employee, patient and member data can be handed over to AI-based systems to reveal insights.
U.S. hospitals lose $262 billion due to denied claims each year….
COVID-19 has heightened the focus on optimized provider data management, utilization management, nurse triage, and telemedicine for payers and providers, both during and after the pandemic subsides.
Throughout 2020 and as we plan for 2021, Sagility has trusted the professional insights of Dr. Virginia Gurley, whose steady and reliable point of view has provided us with a sound perspective regarding the pandemic. Her end-of-year statement offers guidance as well as words of encouragement for the months ahead. “COVID-19 has spread by leaps […]
Health plans are all too familiar with the challenges of member experience—that perfect storm of call/processing volume surge, staffing challenges, and critical moment-of-truth engagement pressures. And the stakes are even higher for 2021, according to JD Power research. The organization’s fourth annual study found that member satisfaction averages dropped from 712 on a 1,000-point scale […]
This year’s open enrollment period takes place from November 1 through December 15, when consumers can select or renew an individual exchange plan either on or off marketplace. For the millions who purchase these plans, the experience can be cumbersome and frustrating as they struggle to make complex decisions based on balancing competing interests of […]
Providers view prior authorization as a manual, burdensome, and laborious process, mostly because of process missteps such as lack of clinical data integration, inconsistency in data exchange standards, and differing policies among payers. According to a recent American Medical Association survey, handling the surging prior authorization requests translates into a “high” or “extremely high” burden […]
Across the world, today’s healthcare organizations are sharing one critical challenge: the rising costs associated with improvement in quality care. The underlying mandate is that all stakeholders must keep a sharp focus on making healthcare more effective, efficient, and affordable. To meet this new demand, both payers and providers have made adjustments to service delivery—and […]
Healthcare systems can better manage denied claims by investing in the front office, improving coding and documentation with technology, improving denial turnaround times, and developing distinct workflows for denials and rejections.
At the heart of all great customer engagement strategies is empathy – especially in healthcare. COVID-19 has created an opportunity for a CX reset that fully recognizes customer emotions.
By Daniel A. Schulte, Senior Vice President, Provider Operations, Sagility As members of the broader healthcare community, we have been reviewing the many facets of the general healthcare delivery environment: from the old-school “diagnosis and treatment plan” strategy to understanding more about the patient’s real-world constraints on the path to wellness. In addition to […]
Healthcare has room to grow in providing a B2C social media experience for members/patients and, for several reasons, should pick up the pace of adoption.
Recent reports show that up to 80% of payers are integrating social determinants of health (SDOH) into their member programs. To address this market focus, Sagility recently sponsored a webinar on Best Practices in Addressing Social Determinants of Health Issues Impacting Highest-Need Populations with AHIP. This well-attended event deserved a follow-up session as there were […]
From an in-control consumer to digital experience and telemedicine, healthcare delivery continues to stretch the limits of what we thought possible. As health plans and health systems increasingly turn to outsourcing partners to compete and thrive in this ever-changing market, we’re here with Sagility’s on-the-ground assessment of Healthcare 2020. And, at the core of the […]