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.
About Virgil Wong
This author has yet to write their bio.
Meanwhile lets just say that we are proud Virgil Wong contributed a whooping 22 entries.
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, representing 10% of the total claims paid. Unraveling the root cause of denials costs an average of $118 for each claim. Applying modern technology — such as analytics, automation, and artificial intelligence (AI) — can help to increase the number of clinical denials investigated, boost appeal effectiveness, and unearth root cause.
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, HGS 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 […]
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.