HGS’s holistic lifecycle management expertise builds long-term relationships that engage and retain your members and patients. As a virtual extension of our healthcare clients, we employ customized solutions to drive real outcomes in the front and back office.
Leading with process maturity, design thinking, cost transformation, and automation. Co-creating and unifying front- and back-office solutions that scale to tomorrow's market changes and demand. All with a member and provider engagement focus.
HGS Health+CARE drives better payer and provider outcomes by:
Enabling a concierge approach, with 24x7x365 service to simplify the coordination of care and flow of information among patients, insurers, and physicians
Integrating the healthcare front office with the claims and back office
Leveraging analytics and the HGS Digital Natural Assist to balance cost per member per month-all to make our payer and provider client partners more competitive by optimizing the healthcare consumer experience
HGS insurance market service delivery across 80 countries is seamless and consistent service from nearly 30,000 personnel in the U.S., U.K., Philippines, India, and Jamaica
Our Health+CARE solution is built on a foundation of empathetic support, operational excellence, and regulatory and compliance adherence.
As a client partner of 5 of the top 10 U.S. healthcare payers, multi-state health systems, and large provider groups, HGS brings transformational care management to these critical areas:
Nurse support - Our 1,400+ nurses are supported by a health information line and nurse triage, level-of-care assessments, and wellness solutions.
Integration of front- and back-office - HGS has proven success of $20 billion in claims payout, 12 million customer interactions, reduced rework, and increased NPS, for both payers and providers, supported by industry-leading compliance - HIPAA, GLBA , URAC, ISO 9000, ISO 27000, SAS 70.
Scale - HGS employs more than 15,000+ Healthcare professionals, to provide our expansive capabilities and solutions to 100,000,000 members served.
Global experience - HGS insurance market service delivery across 80 countries is seamless and consistent service from nearly 30,000 personnel in the U.S., Canada, U.K., Philippines, India, and Jamaica.
Consultative approach - We provide a cost-containment focus that comprises solutions across marketing, engagement channels, and CX strategy.
Wellness management - HGS specializes in health risk at enrollment, case and utilization management, and healthy products.
There are three foundational pillars to the HGS Health+CARE Services operating model and enabling technology platforms that ensure the best possible outcomes.
Building promoters with accurate, empathetic support to members
Effectiveness and Efficiency
Care Expertise + People, Process, Technology
Addressing Regulatory Challenges and Compliance
Unified Engagement + Lower Cost = Better Member Experiences (Outcomes)
Can engaging with us improve your bottom line? Definitely. Consider this example. In 2015, HGS helped achieve significant savings and transformation for one of the top five U.S. payers, with 94.2% reduction in multiple reach-outs to brokers. Read about our partnership success here.