Managing appeals and grievances is labor intensive and challenging as it involves keeping up with the policies and guidelines regulating the process while providing greater transparency to member and providers on the process. Payers are further paying fines for not handling appeals and grievances timely and accurately.
Our platform allows digital submission of appeals in a guided fashion that notify on chances of appeal overturn or upheld decision during submission, compliance with medical policy and medical necessity and provides insights and transparency to documentation needs, form completion accuracy to reduce time taken to resolve and volume of appeals.