For Health insurers, an important aspect of delivering exceptional service is how well they respond to provider appeals and grievances (A&G).
With the OnBase Insurance Solution, Heath insurers manage incoming A&G through a provider portal or by mail, fax or email. Once in OnBase, distributing the appeals according to type is easy as most appeals are financial in nature - a claim has been denied or rejected, and after three attempts, the A&G process is the provider’s only recourse.
OnBase also assists Health insurers with provider relations during sales campaigns. An OnBase provider portal offers providers an opportunity to request sales campaign support - capturing information about the sales activity, what additional support is needed, and what funds are required. The OnBase business process management tool (OnBase Workflow) manages these requests, assigns tasks, notifies providers to send status updates on the sales campaign and monitors time constraints required for decision/support.