Provider Relations Solution helps Health insurers deliver exceptional service

Healthcare Payer

Providers measure health insurers by how well they respond to appeals and grievances (A&G) – and slow, manual processes won’t earn many five-star customer service ratings. Speed response times while improving quality with OnBase. 

Automate capture and distribution

Starting with the all-important capture stage, the OnBase Provider Relations solution helps health insurers:

  • Manage and automate incoming Appeals and Grievances
  • Electronically capture data from forms submitted through a provider portal, fax, email or postal mail  

Once in OnBase, workflows route and distributes A&G’s according to type, team or line of business.  Through the A&G distribution process, OnBase:

  • Tracks each step in the process, offering a full audit trail for better reporting and compliance
  • Automates rules and triggers throughout to make sure the appeal or grievance follows the appropriate process, business rules and compliance regulations
  • Generates alerts and triggers events – it will even automatically generate letters

And, integrating OnBase with your Claims and Care Management solutions will leverage your investment even further, adding additional capabilities while increasing the value of existing technology.

Streamline sales campaigns

OnBase also assists health insurers with provider relations during sales campaigns. Providers may request sales campaign support through an online provider portal that captures information about the sales activity, any additional support that might be needed and what funds are required. OnBase manages these requests, assigns tasks, notifies providers to send status updates on the sales campaign and even monitors time constraints required for decision/support.