Serving All Facets of the Healthcare Member Lifecycle, from Enrollment to Care Coordination and Wellness
As a result of the Affordable Care Act, individual and family enrollment has seen a significant increase. The right lifecycle focus includes an enrollment feature that answers today's new healthcare consumerism demand.
HGS provides licensed insurance agents on the exchange to bring your customers into the digital marketplace. We also currently employ 1,100 clinical staff members, many of whom carry US RN licenses offering Utilization Management, Case Management, and Care Coordination. Additionally, our member support staff works to improve member experience and provide denials management and explanation of benefits, including handling of customer queries. Over our history, HGS has become the partner of choice for five of the top ten insurance payers within the United States. Our clients count on us for our expertise, credentialing, and customer care focus.
How We Do It
Provide member support services for individual, group, commercial, and Medicare plans.
Provide Health Information Exchange (HIE) and co-op support, with end-to-end sales support by a licensed insurance agent providing customer support and education.
Colibrium 360 platform provides an efficient and consistent end-to-end shopping experience focused on the acquisition, engagement, and retention of health plan members.
Provide management of disputes and grievances.
Plan sponsor reviews, including sales support and quoting, product build testing and certification, premium billing and reconciliation.
Ensure Health Risk Assessment (HRA) and enrollment with open enrollment support, new member enrollment, renewals, and terminations.
Ensure wellness follow-up, with member education, wellness appointment reminders, and enrollment.
Provide policy maintenance.
"We are extremely excited by your proactive approach. It is great to know that HGS is looking out for us and working to find ways to improve our process and save us money. This is a great example of Perfect Service, which is a principle that [our company] strives for. We very much appreciate all that the whole team does for us on a daily basis."