How Hyland Solves The Scenario Jane’s Challenges In this example, let’s imagine how the Helping Members member services manager at an insurance 1. Jane receives a call from a member wanting to know why her organization uses Hyland to provide timely insurance claim for physical therapy was denied. information to members, physicians, and 2. Jane views the record in Salesforce and sees that the order for third-party payers. physical therapy is present, but it was a written order. She accesses it in the Hyland content services solution and sees that some information is missing. 3. She checks with the claims department and they tell her the claim was returned to the provider for more information. Jane shares this with the member and notes it in Salesforce with a follow-up reminder. 4. A week later, Jane checks on the claim and sees it is paid. She looks the patient up in Salesforce and follows up to let her know that the claim has been approved. Jane then updates Jane Callback her notes in Salesforce so she will have the history behind this Member Services Manager, call for future reference. Insurance Co. Tracking Provider Credentials Her Goals: Her Challenges: 1. Jane sees alerts in Salesforce for soon-to-expire and expiring credentials for doctors in her organization’s care network. Jane spends her days • Minimize the number of steps • Time lag from request to response to access, update, and share due to numerous systems that 2. Jane sends emails to hospital administration and the doctors responding to member information need to be accessed and updated requesting they issue current credentials. requests for information or • Provide only the most accurate • Ensuring information is accurate 3. The hospitals and doctors she reached out to send back concerns. She takes a lot and up-to-date information to and secure updated credential information. Jane imports the credential of calls and has difficulty members while keeping data safe • Quickly and accurately routing documents into Salesforce using the OnBase Integration for remembering who has called • Use just a few steps/clicks to a member’s request for follow-up Salesforce. She then applies field values for the documents about what and which is the update a member’s record and to the correct department and saves the records. right department to route their forward the need for follow-up concerns to for follow-ups. to the right department 4. This updated information ensures that the associated doctors • Send time-based notifications and the hospitals where they practice can be listed in their regarding credential expiration to provider network. hospital administrative staff, as well as the doctors themselves, so they can take action Learn more about Hyland