Social Determinants of Health: Insights from our Experts
Recent reports show that up to 80% of payers are integrating social determinants of health (SDOH) into their member programs. To address this market focus, Sagility recently sponsored a webinar on...
View ArticleHealthcare Customer Engagement: Charting an Empathetic Experience
Imagine this scenario: You are in the hospital after an emergency appendectomy, and you have a simple but urgent question about payment of this (just-delivered) health service. Your physical and...
View Article4 Ways that Healthcare Systems can Manage Denied Claims
Provider healthcare technology has progressed rapidly to advance clinical care. Despite the leaps forward in provider technology, innovation has been comparatively slow for most providers’ financial...
View ArticleBridging Provider-Payer Gaps with Today’s Technology
Across the world, today’s healthcare organizations are sharing one critical challenge: the rising costs associated with improvement in quality care. The underlying mandate is that all stakeholders...
View ArticlePrecision Utilization Management: Meeting Patients Where They Are
Providers view prior authorization as a manual, burdensome, and laborious process, mostly because of process missteps such as lack of clinical data integration, inconsistency in data exchange...
View ArticleSeamless Customer Experience Begins with Enhanced Direct Enrollment
This year’s open enrollment period takes place from November 1 through December 15, when consumers can select or renew an individual exchange plan either on or off marketplace. For the millions who...
View ArticleMember Experience: Never a Better Time for Digital Enablement
Health plans are all too familiar with the challenges of member experience—that perfect storm of call/processing volume surge, staffing challenges, and critical moment-of-truth engagement pressures....
View ArticleFor Better RCM, Prioritize People and Track with Technology
Across the healthcare industry, health information mismanagement is causing a loss of millions of dollars each year. Inefficient use of staff resources and systems, or the failure to invest at all,...
View ArticlePreventing and Appealing Clinical Denials with Analytics, Automation, and AI
U.S. hospitals lose $262 billion due to denied claims each year, representing roughly 10% of the total claims paid. Unraveling the root cause of denials costs an average of $118 for each hospital...
View ArticleThree Ways Healthcare Engagement Models Differ from Other Industries
First published on May 23, 2018, by Austin Ridgeway, Director, Sagility; refreshed on June 1, 2021 Over the past couple of years, there has been a lot of industry buzz about what retail can teach...
View ArticleThe Human Side of Healthcare Analytics
Capturing a consumer’s emotional response to a service or sales experience is increasingly vital to their interaction with a brand. The pandemic has made this fact increasingly clear, with both...
View ArticleHealth Plan Guidance: 3 Essentials for No-Surprises Act Compliance
In recent years, the healthcare industry has increasingly been paying attention to the error rates in health plan directories. Undependable directories create poor member experience by impacting...
View Article5 Provider Coding Myths, Debunked
Over the past 18 months, healthcare providers have grappled with historic cost and care challenges. The COVID-19 pandemic has increasingly forced providers to assess new areas of transformation to...
View ArticleBuilding a Successful Data Culture in the Post-Pandemic Healthcare Reality
Postponement of nonessential surgical procedures early in the coronavirus pandemic not only disrupted surgical care at U.S. hospitals, but also took away a large portion of hospitals’ total income,...
View Article3 Payment Integrity Imperatives in Post-Pandemic Healthcare
Even pre-COVID-19, claims fraud, waste, and abuse (FWA) was a top-of-the-agenda issue for health plans aiming to evolve both care quality and consumer experience expectations. But the pandemic has...
View Article3 Fresh Ideas for Winning the Competition for Healthcare Talent
The past two years have brought a perfect storm of challenges for healthcare providers. COVID-19 has had a profound impact on healthcare overall—resulting in one of the all-time worst financial crises...
View ArticleSagility Future Digital Series: Front-Office Accelerators
Bridging journey gaps through the digital front door In terms of optimized healthcare experience delivery, the digital front door has been less an entry point and more an essential touchpoint of the...
View ArticleHow Back-Office Accelerators are Steering Optimized Experience
The digital age has shed new light on the need for interoperability for healthcare, as backed by recent imperatives such as the Centers for Medicare & Medicaid Services (CMS) Fast Healthcare...
View ArticleSagility: Voice of the Consumer
Modernized, AI-enabled VoC to Meet Today’s Healthcare interactions Today’s healthcare members will act on failure to meet their expectations, according to recent Forrester research, with 34% of...
View ArticleThree healthcare cloud myths, debunked
Three healthcare cloud myths, debunked With ever-increasing, rigid regulations, and the most sensitive personal data of any industry, healthcare has walked slowly toward technology and transformation....
View ArticleTransformative AI to revamp prior authorizations
TRANSFORMATIVE AI TO REVAMP PRIOR AUTHORIZATIONS Tech enablement drives lower costs, lessened provider abrasion Health plans are unnecessarily burdened by administrative tasks such as prior...
View Article4 ways to win with claims denials
Facing both revenue and expense issues and exasperated by clinician shortages, hospitals are increasingly noting denials in the danger zone. “Danger zone” translation: Denials are increasingly higher...
View ArticleBPO, Supercharged: Business Process as a Service Drives Scale, Savings While...
BPO, supercharged: business process as a service drives scale, savings while exponentially enhancing outcomes By Srikanth Lakshminarayanan, , Senior Vice President, Center of Excellence for Healthcare...
View ArticleOptimizing Operations and Improving the Provider Experience through...
UM and prior authorization, which is the most commonly practiced form of utilization management, are both highly regulated, and health plans can face high penalties and fines when they are out of...
View ArticleFiscal Health for Providers: Precision Cost Takeout in 3 Areas
By Titus Leo and Jason Besterfeldt As today’s hospital margins are increasingly in the red, and health systems are asked to do more with less, all eyes are on cost removal. According to a recent...
View ArticleSagility Experts Weigh In: As-a-Service Solutions Drive Improvements for Payers
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