Xerox Workflow Automation Solution for Appeals and Grievances – Healthcare Payers / Insurers

Appeals and grievances arrive at your office daily in any form, from hard copy to online portal, and could be a life-or-death matter requiring immediate attention.

Xerox Workflow Automation Solution for Appeals and Grievances automates the manual aspects, making the entire process trackable and more efficient.

Providers and patients submit materials through an easy-to-use interface. The information is captured and classified using a set of criteria to determine if the appeal involves a life-threatening situation.

Then assignments are prioritized, evenly distributed among coordinators, and routed to the right parties for review and approval. An acknowledgement letter, determination letter or payment authorization notice can be created by the system.

Workflow Automation for Appeals and Grievances can help healthcare payers / insurers:

• Deal with high volumes and meet tight deadlines.

• Keep a detailed, trackable trail of every approval and document.

• Address status issues with real-time reporting and dashboards.

• Reduce time, labor and costs associated with manual processing by 30%–50% per appeal.

• Improve response time for members and providers.