Member and customer satisfaction
Thanks to OnBase, there’s no need to call UMR and wait on hold for a service representative to look up the member ID, see if an appeal has been received, check on its status and determine if additional documentation is needed. The integration with OnBase allows members to see the status of their appeal directly within the UMR portal.
Fewer calls to find documentation and check on A&G status means staff have more time for clinical review, consideration and decision. Personnel no longer waste time looking for member documents because they are available for enterprise access within OnBase. Real-time monitoring also helps prevent staff from missing state deadlines. Automated routing and correspondence expedite completion of the appeals process.
The rules-based A&G software with real-time reporting dashboards provides for timely management of appeals based on each plan or state’s regulatory guidelines to prevent fines and other penalties. It is easily adaptable to support changes in statutes.