eBook

Five Reasons Your Appeals and Grievances Process Hurts

Find out how you can overcome process challenges and make progress towards a happy member.

Appeals & Grievances process hurts in terms of money, efforts, and reputation

There’s an enormous cost incurred behind every appeal filed whether upheld or not. According to the Annual Report of Medicare Reconsideration results, out of 46,377 appeals, 71% of recons were upheld with a contested claim value of over 100 million dollars.

Member expectations are increasing! And, so as their Appeals & Grievances!

Healthcare payers are facing pressures from multiple dimensions. One key dynamic with a long term impact is the increase in member expectation due to the increase in overall access to information including their rights combined with better member experience in services across industries.

What are you doing about it?

While health plans are full of intent to become operationally more efficient, they are often stuck with challenges that are not easy to fix without an optimum strategy. So, to know what needs to be done to address issues, understand the actual reasons why the process really hurts.

Download this ebook to find 5 areas of Appeals & Grievances process that calls for your immediate attention!