Health Plan Grievance Management
Streamline compliance processes, ensuring accuracy and timeliness from intake to resolution.
Designed for health plans navigating Medicare and Medicare Advantage, we offer a unified solution to manage grievances and appeals intake efficiently.
A better way to handle beneficiary grievances
Managing grievances is a critical component of engaging with health plan beneficiaries. Resolve cases quickly and appropriately for enhanced member satisfaction and avoid noncompliance.
Insightful Interactions
Capture detailed member interactions to identify grievances more clearly.
Unified Interface
A one-screen view ensures case processors can capture and process the entire “story” of an appeal or grievance.
Guided Compliance
Seamlessly navigate complex CMS processes, ensuring compliant resolutions every time.
Timely Resolution
Ensure quick and appropriate case resolution, a key component of member satisfaction and compliance.
Continuous Improvement
Enable root cause analysis with complaint research and initiate process improvements for long-term satisfaction.
Discover key grievance management features
Complaint Research, Tracking, and Resolution
Root Cause and Missed Opportunity Analysis
CMS-Required Fields and Functions
Thorough Case Validation
IRE, ALJ, MAC, and JR Case Levels
Full Dismissal Processes
Official Re-openings
Ready to discuss enhancing your enrollment and premium billing process with grievance and appeal functionality?
