Audit & Monitoring
Efficiently audit and monitor compliance readiness by centralizing and automating critical processes.
- View audits and monitor process data in real time
- Track findings, recommendations and action plans
- Generate on-demand reports and analytics
Confidently guide health plans to manage risks relevant to their businesses with real-time data.
- Manage contract life cycles
- Implement contract analytics
- Track all contract parameters
Appeals and Grievances
Resolve the disconnect between multiple legacy systems to effectively engage members at every touchpoint in real time.
- Adhere to appeals and grievances compliance deadlines and requirements
- Monitor changes at each state of the complaint process
- Track and trend sales allegations outcomes
Centralize critical data to meet government healthcare programs and commercial health-plan compliance requirements.
- Achieve compliance program effectiveness (CPE) objectives
- Ensure CMS Program Audit compliance
- Generate universes for Medicare, Medicaid and commercial plans with the touch of a button