Enabling Broadened Offerings, Improved CSAT for Providers

In this post-reform era, individual and family enrollment has seen a significant increase. The right lifecycle focus includes dedicating resources to the efficiency of network management, claims accuracy, and medical cost management, to lower costs, improve provider and member satisfaction, and make healthcare more accessible. HGS Provider Lifecycle Management Services comprise solutions that focus on provider engagement and back-office processes, as well as complementary services.

We currently employ 1,100 clinical staff members, many of whom carry US RN licenses offering Utilization Management, Case Management, and Care Coordination. Our member support staff works to improve end-user experience, provider denial management, explanation of benefits, and 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 domain expertise and customer care focus.

How We Do It

HGS Provider Lifecycle Services include:

  • Contracting and onboarding
  • Provider support and experience management
  • Credentialing
  • Database management
  • Network management
  • Quality surveys and reporting
  • Provider score card management
  • Provider performance analytics
  • Colibrium 360 platform support

Along with our Provider Lifecycle Services, HGS also offers more provider services: financial clearance, coding accuracy, cash recoveries, and denial reversals. We support clients during specific times of need such as pressures on cash flow, including patient accounting system conversions, process transformation and redesign efforts, staff turnover, and talent recruitment challenges.

Our Value

HGS provider lifecycle services offer benefits such as:

  • Reduced turnaround time (TAT) of provider credentialing and provider re-credentialing by 20% through consolidated work flow management
  • Reduced denials rework through provider education by 25%
  • Responsive and proactive account handling
  • 50% improvements in operational efficiencies in provider credentialing and database management
  • Payer-provider insights consortium that has reduced repeat calls by 4%
  • Cost management

"As a result of HGS's informative monthly reporting, we were able to address areas of opportunity and prevent future accounts from aging."

Leading U.S. Health System

2-10% higher CSAT, NPS than client targets

of Top Healthcare Payers Supported
Healthcare Professionals
Serving Members on behalf of Payers and Providers
Industry-Leading Compliance
100% Client Retention