Maximize Operational Efficiencies

Health plans are working to cut paperwork, eliminate manual processes, improve accuracy and reduce costs across their enterprise. Like many out there, you may be missing out on opportunities due to out-grown processes and technologies.

Accelerated Product Implementation

Are you getting your products to market fast enough?

The sooner your product gets to market, the sooner you begin seeing a return on investment. Our consultants can help you deploy an end-to-end product delivery solution that will bring your new product from ideation to market launch quickly while minimizing defects.

Operational Reengineering & Optimization

Are your claims management processes optimized from a financial, fraud, customer service and provider relations perspective?

The high volume of claims made and claims paid makes process efficiency vital to your operational success. Our consultants can work with you to streamline business processes, analyze critical data and enable technology to improve the quality and efficiency of your quote-to-bill administration solutions.

Customer Service Enhancement

Does your service experience exceed member expectations? Do you provide a single interface to your customers through the web, e-mail and call center?

If you’re not leveraging every touch point with members, you’re missing an opportunity. Our consultants help you strike the balance between efficiency, quality and the customer service experience. This ensures you exceed member expectations, lower costs and deliver appropriate care management campaign messaging.

Ingenix Consulting helped a Fortune 50 payer develop a customer service strategy that drove $11.6 million to the bottom line through reductions in inbound calls, training costs and average handle time, as well as increases in cross-selling, agent productivity and call quality.

Enterprise Information Management

Do you understand the data that you have and how to get the most out of it?

By leveraging data and reporting, you can consistently make enterprise-wide decisions with confidence. We can help you interpret information and metrics real-time to understand performance and the root causes of issues. By defining key metrics, acquiring and managing the data, and making it easy to access, we are able to help you better identify areas of opportunity.

Compliance

Are you ready for ICD-10 & HIPAA 5010? Do you understand how the current reform initiatives will affect your business? 

Creating programs around regulatory compliance and risk management will not only make you more efficient but also minimize monetary losses. Our consultants can help you define, implement and audit compliance programs. We also work with you to navigate the significant changes for ICD-10 and HIPAA 5010.

Payment System Integration

Are you confident that your claims are being reviewed and paid correctly? 

Errors in payment add up quickly, making a pricing control strategy a smart investment. We provide process and system recommendations that give you more appropriate and efficient alignment of payment risk, control of overpayments, detection of fraud and abuse, and can reduce coding and billing errors.