A SAAS THAT PROVIDES AN ENTIRE SUITE OF A&G TECHNOLOGY
Companies focusing on customer centricity, efficient process, effective use of data, and partner enablement consistently outperform their competitors while turning their customers and partners into promoters
Workflow-Driven, Intelligent A&G Case Management
With the ever-increasing challenges of business rules, operational procedures, service level agreements, regulatory requirements, unpredictable volumes, error-prone procedural issues and medical management; handling appeals and grievances (A&G) is an intricate, complex and manually intensive process.
Compliant A&G breaks down these complexities with an automated approach that allows you to efficiently address member and provider complaints and appeals while gathering insightful, evidence-based data to improve quality, increase performance and reduce risk.
Automate the tedious manual efforts associated with managing A&G cases and augment decision making.
2 SIMPLIFY YOUR OPERATION
Guide your teams with configurable rules engines, dynamic wizard-driven forms and interfaces, and on-screen operating guidance
3 IMPROVE STAR RATINGS, AVOID PENALTIES
Ensure compliance, timeliness, and quality with Medicare and Medicaid rules engines enforcing case rules
4 IMPROVE OUTCOMES & QUALITY
Augment knowledge workers by giving them the data they need when they need and enforce service level compliance
5 GAIN ACTIVE & HISTORICAL INSIGHTS
Search and explore vast amounts of constantly shifting A&G data - all of it - A&G Case, Enrollment, Plan, Benefit, Claim, and Authorization
SOFTWARE (& COMPLIANCE) as a SERVICE
The percentage of time the service has been up (Zero-Downtime)
The number of security breaches
The amount of non-compliance penalties paid by our customers
SOME OF OUR CLIENTS INCLUDE
Need to increase your Star ratings and avoid penalties?
Automate compliance and boost quality scores with industry leading Medicare and Medicaid Compliance Rules Engines. Additionally, stay on top of increasing regulatory requirements with our Compliance as a Service.
Medicare and Medicaid Rules Engines / Compliance Monitoring Service
Want to improve outcomes as well as quality?
View your vast amounts of constantly shifting G&A data - all of it. You're not constrained by preconceived notions of how data should be related, but can finally understand how it truly is related. Analyze, reveal, and act.
With built-in Qlik Analytical Dashboards Specific to G&A
Want to improve efficiency and reduce costs?
Automate the tedious administrative tasks associated with managing grievances and appeals, such as: Data Entry, Data Aggregation, Letter Generation, Pending for Information, Follow-Ups, Notifications, and Alerts.
Process Automation Toolkit
WHAT MAKES CAG BETTER
CAG is purpose built specifically for the needs of A&G teams, providing an end-to-end (one-stop) solution for A&G intake, triage, investigation, resolution, management, and reporting.
Business & Compliance Rules
Business Rules Validation
Compliance Rules Validation
Configurable Work Distribution and Prioritization
Integration & Collaboration
360° Case View w/ Integration Accelerator Framework
Cloud Collaboration Suite
Work Distribution and Prioritization
Letter and Report Generation
Pending and Follow-Ups
Alerts and Notifications
Get A Glimpse of CAG
Watch the Explainer
Dramatically improve the efficiency and effectiveness of your operations with CAG.
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Get in Touch
Inspire Innovations - CAG Group 85 Broad St. 29th Floor, NYC