In the emerging value-based world, today's providers are increasingly aligning incentives to drive improved patient health outcomes, more patient-centric services, and reduced medical cost for the individual.

This changing landscape provides unique opportunity to leverage a new breed of clinical expertise—one that brings new operational focus and value. HGS provides that solution via our licensed care professionals who support health information lines, nurse triage, level-of-care assessments, and wellness solutions. Our 15,000 healthcare professionals, including 1,500 registered nurses, employed across our provider and payer business lines, are brand ambassadors for our provider clients, actively supporting health information lines, nurse triage, level-of-care assessments, and wellness solutions. These team members bring a distinctive combination of professional certification in their respective specialties, deep domain knowledge, agile workflow innovation, and call center expertise with empathetic and patient-focused service focus.

"U.S. hospitals are accelerating and diversifying their digital healthcare program particularly using the web to engage and monitor patients, according to a 2016 American Hospital Association study."

How We Do It

What started as a mix of standard clinical intake and benefits and eligibility calls has expanded to include processes that require even greater sensitivity, clinical knowledge and judgement—a scope that today includes case management, medical necessity review, and level of care assessments. These clinically skilled team members provide:

  • 24 x 7 Nurse Triage (omni-channel support options, including voice, chat, and text)
  • Physician and Pharmacy Coordination
  • Clinician Engagement
  • Care Coordination
  • Case Management

Our Value

HGS Licensed Care Professionals offer benefits such as:

  • Cost containment, supported by rightshoring approach and innovative solutions such as intelligent automation and omnichannel support
  • Improved patient and provider satisfaction, with enhanced STARS scores, NPS, CSAT
  • Reduced turnaround time (TAT) of provider credentialing and provider re-credentialing
  • Reduced denials rework
  • Responsive and proactive account handling
  • Provider-payer lifecycle expertise and focus comprising data-sharing and insights
  • Reduced overhead with better workflow of patient scheduling, education, point of service collections and enhanced care coordination, to reduce administrative overhead.
Serving Patients on behalf of Providers and Payers
Industry-Leading Compliance
Holistic Provider-Payer Lifecycle Focus