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SOLUTIONS

FRAMEWORK

Policy Owner Services

BizFlow provides BPM-based case management frameworks for automating New Business, Underwriting, and Policy Maintenance processes. With it users initiate, manage, review, and track work. They manage absences, create notifications, forward, escalate, and pend work. Managers decide roles and responsibilities, dictate workflow distribution logic, monitor assigned cases, review vacation requests, create metrics, and run reports. The resulting insight, automation and adaptability lead to better use experiences, improved productivity, and deeper customer relationships.

FRAMEWORK

Claims and Customer Service

BizFlow provides BPM-based case management frameworks for automating Customer Service and Claims processes. Customer Service frameworks enable users to initiate and track correspondence as well access and edit documents. Managers can assign roles and responsibilities, determine workloads, and monitor assigned cases. Whether cash, credit, life, personal accident, PPO, or pre-approved claims, BizFlow claims frameworks enable all steps of intake, distribution, adjudication, approval, and payment. Users get complete visibility into process activities, correspondence, and documentations. Managers see workload and potential bottlenecks. Everyone gets access to data to measure and improve productivity.

FRAMEWORK

Appeals and Grievances

BizFlow provides Compliance A&G, a BPM-based case management framework that streamlines Appeals and Grievance (A&G’s) processes. By law members of Health Insurance providers have the right to appeal any decision made by the provider. Members may also submit grievances expressing dissatisfaction with any aspect of the operations, activities or behavior of a Medicare health plan, or its providers, regardless of whether remedial action is requested. Providers who do not strictly follow the laws involving Appeals and Grievances are subject to regulatory fines. Annual costs of managing such programs for a mid-sized medical insurance can quickly exceed $500,000, for large HMO’s more than $1M/year. Compliant A&G automates appeals and grievances operations from intake, distribution, assessment, and issuance. Training is made easy as case managers only have one solution to learn.

FRAMEWORK

Human Capital Management

BizFlow provides BPM-based case management frameworks for standardizing and automating human capital management operations (employee-to-benefit, hire-to-retire processes).

…and Many More
  • Action Tracking
  • Accounts Payables
  • Asset Management
  • Billing
  • Capital Expenditures
  • Case Management
  • Claims
  • Customer Service
  • Customer Relationship
  • Management
  • Grant Management
  • Human Resource Management
  • Inspections
  • Internal Controls
  • IT Service Management
  • Licensing
  • Loan Origination
  • Permitting
  • Policy Management
  • Procurement
  • Product Development
  • Remittances
  • Renewals
  • Succession Planning
  • Sales Management
  • Transmittals
  • Underwriting