The Challenge After many years of customizing and developing applications on the Salesforce platform, one Worker’s Compensation PBM faced several challenges with the administration and maintenance as a result of their customizations. The client had created core applications, including Quoting, Claims, and Sales Automation Management, with a significant amount custom code and data objects. The …
Category Archives: Success Stories
Provider Network Management
The Challenge As the healthcare industry continues to undergo dynamic changes and rapid expansion, there is an immediate need to streamline processes and align data sources for optimal efficiency. Provider Network Management (PNM)_business practices and systems are outdated and inefficient, plagued by demanding back-office maintenance and low-quality data. The credentialing process historically has been especially …
Individual and Family Shop & Enroll
The Background The Affordable Care Act ensures that every person has access to health insurance and that Individual and Family health insurance is available for people and their dependents. Generally, those who do not qualify for Medicare or insurance through an employer (such as Small Group or Large Group plans) will seek out this type …
Medicare Advantage Shop & Enroll
The Challenge Medicare is among the largest and fastest-growing segments in healthcare. Created in 1965, the federal health insurance program today has 64 million seniors enrolled. Each year, approximately four million Baby Boomers are aging into Medicare, more than 10,000 a day, and the number of beneficiaries enrolled in the program is projected to reach …
Small Group Shop & Enroll
Overview Within health insurance, a “Small Group” is generally considered to be any company with 2-50 full-time employees. While Small Group companies are not required to offer insurance to their employees, they will often see many benefits when they do, including attracting employment candidates, increased staff retention, and tax credits. Health insurance is considered an …