By eliminating email, Health Plans resolve Complaints, Appeals and Grievances faster

A panel discussion at the recent RISE conference emphasized how eliminating the use of email for performing Complaints, Appeals and Grievances outreach helps plans resolve cases faster and manage timelines better.

Inspire Innovations

Inspire Innovations, a member of the Managed Care Resource Alliance and an InsureTech consulting and software firm today announced its ongoing commitment to help Health Plans transform their Complaints, Appeals and Grievances operations by launching CAG Outreach TM, a secure software solution that replaces email for internal and external correspondences for Appeals and Grievances case resolution.

"Secure online Tasking capabilities have always been an integral part of our Case Management software. Now we are making this unique capability a stand-alone option called CAG Outreach TM Health Plans will be able to utilize our solution no matter what system they currently use as their core Appeals and Grievances case management system," said Tyson Slater, Director at Inspire Innovations.

CAG Outreach TM  is a HITRUST certified cloud-based software as a service based on the latest micro-services technology and robust integration framework to be securely and quickly integrated with a health plan's existing business systems. With CAG Outreach Plans can perform outreach electronically online including: 

  • Sending Requests for Information and investigation of Member Issues
  • Seeking Clinical reviews of initial decisions or other details on initial denials
  • Requesting Effectuation of Appeal Decisions

Proven features include: 

  • Quick and Secure Task Creation with pre-population of relevant case data to avoid rekeying data
  • Email like simplicity for both Task Assignor and Task Recipient to speed adoption
  • Individual and/or group task assignments
  • Requests for clarification and time extensions by recipients
  • Setting of deadlines and alerts for tracking SLAs
  • Attachment of documents
  • Audited real-time discussion threads for rapid collaboration
  • Task Status and Reporting

"Appeals and Grievances departments within a Health Plan rely heavily on other departments and delegate organizations to quickly resolve complaint and appeal cases. Using email is a challenge because it cannot be tracked or reported on. The tasking capability provided by CAG Outreach allows our clients to track requests for information from other departments, providers or partners through a trackable and reportable system," said Daniele Chenal Director of Healthcare at Inspire Innovations. "This significantly speeds up the resolution process and holds everyone accountable to timelines." she continued.

You can learn more about CAG Outreach TM and our entire suite of Complaints, Appeals and Grievances software solutions by requesting a product demonstration at: https://cag-cloud.youcanbook.me or reading a Complaints, Appeals and Grievances Workflow Automation Case Study.

Inspire Innovations currently works with some of the world's most successful healthcare and insurance companies to help them achieve their transformational objectives. For more information, visit Inspire Innovations at www.InspireInnovations.com.

Source: Inspire Innovations

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Categories: Healthcare Technology, Healthcare Insurance

Tags: Appeals and Grievances Software, CAG Outreach, CAG Software, Complaints Appeals and Grievances Automation, Complaints Appeals and Grievances Case Management


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