Health Plan Operations
Because Health Plan Operations includes essential transactional functions like claim processing, enrollment and billing, and customer service many plans see it as merely “table stakes.” However, being brilliant at the basics can set a plan apart. So errors in these areas not only result in customer dissatisfaction and lost membership, they are the most likely to result in CMS civil money penalties.
A knowledgeable partner understands that all plan functions are interrelated and require expertise to maximize value. A claim isn’t merely a claim; it’s an insight into health trends and risk. A customer call is not just an opportunity to strengthen a relationship but could be the catalyst for a grievance and appeal.
Synovia Health can help you avoid costly toe stubs and help you retain members in a competitive marketplace, ensuring your plan achieves the high performance that contributes to plan profitability. As your experienced partner, we can provide a full suite of operational functions to help you avoid costly mistakes and achieve high performance quickly.