A Better Consumer Health Experience Begins with a Good Total Business Model

Concentrix Corporation
Written by Claire Suttles

The healthcare industry continues to grow and face new challenges, creating an ongoing need for innovative, up-to-date solutions that drive down administrative costs while improving medical loss ratios. Global healthcare spend already makes up 10.6 percent of the gross domestic product and this spend is forecast to grow more than 5 percent annually as the number of people aged 60 and above rises from 12 percent of the population in 2013 to 21 percent in 2050. To meet the increasing demands, the industry must integrate new technology solutions to improve efficiency and develop new delivery models…
Concentrix Health Practice’s team of 5000 healthcare specialists and subject matter experts are ready to support the industry as it makes these adjustments. This team of healthcare experts offers end-to-end health plan services and consulting throughout the member lifecycle for all plan types, both commercial and government. By working closely with clients, the team is able to enhance member experiences and earn brand loyalty from customers while slashing administrative and medical costs.

The Concentrix Health Practice understands that consumer-centric delivery services coupled with technology, digital, media, and mobile telecommunications are converging to create a new era of technology-enabled healthcare services. Harnessed properly, this 21st century approach to healthcare service delivery will dramatically improve business processes and save the industry a significant amount of money.

But the healthcare industry must learn to leverage leading-edge mobility applications and communication technologies in order to increase connectivity, engagement, and brand loyalty among customers or, in other words, taking advantage of the critical opportunity to engage with its end-user communities. Concentrix Health Practice’s team of experts helps clients automate business processes while making the most of modern communications to improve their customers’ experiences and ease of interaction.

The growth of the retail healthcare market and member-centric coordinated care has also created new challenges for healthcare enterprises. Concentrix Health Practice understands this shifting landscape and, by utilizing their consumer retail experiences, digital, and omni-channel solutions, is able to develop services for clients that reflect the needs of their customers. Obviously, by offering exceptional service, clients win loyalty from their members and patients while cementing their place in the market.

Concentrix Health Practice offers a full suite of solutions to meet the industry’s varied needs. Membership services include:
•case installation
•new member enrollment
•member maintenance

Contact services cover:
•E2E member care
•provider support
•open enrollment

Claims Lifecycle Management deals with:
•adjustments and recoveries
•member CG&A
•quality audits
•all types of adjudication
•Provider Services include:
•provider setup
•contract processing
•provider CG&A.
Analytical Services cover:
•Business Intelligent Reporting (BIR)
•automated claims auditing
•member lifetime value analytics
•voice of member analytics

Whatever the specific service, Concentrix Health Practice works hand in hand with clients to deliver personalized, member-centric solutions across front and back office processes. This improvement process often begins by asking the client a foundational question: What is your member/patient strategy? With that knowledge in hand, the team then assesses a client’s processes to identify what can be improved and automated—and then they work to make those improvements. “We partner with our clients to realize their strategies by providing solutions that maximize the value of every consumer interaction, while driving revenue and reducing cost,” Concentrix summarizes.

Concentrix Health Practice has the résumé needed to win clients’ trust and deliver individualized solutions. The company has provided end-to-end services specific to healthcare plans for over 13 years and earned the business of the majority of the top 10 largest health plans in the United States. The team boasts in-depth experience in all member care and provider contact services—from outreach and correspondences to appeals and provider network management services. On average, the company’s healthcare practice experts have more than a quarter century of combined CRM operational and healthcare services consulting experience.

“This unique combination of hands-on expertise with strategic health industry insight allows us to assess, design and implement innovative, yet practical solutions that yield significant and measurable results,” Concentrix points out. For instance, Concentrix Health Practice improved accuracy for a leading United States healthcare provider by 25 percent. The team also increased customer self-service from 9 to 36 percent while raising customer satisfaction scores by 12 points for a top ten multi-vertical enterprise. In addition, Concentrix consultants improved enrollment and billing time to process between 10 and 20 percent for a U.S.-based non-profit healthcare payer.

To provide such game-changing results, the team focuses on three service areas:

Customer Experience – Customer experience is now a primary competitive battleground for many of Concentrix’ clients as they seek to connect with their customers, differentiate from the competition and increase brand loyalty.

Channel Optimization – Rapid customer adoption of expanded channel choices and rising customer expectations for a seamless cross-channel experience have created challenges for many companies as they seek to deliver consistent, integrated and cost effective interactions.

Operational Excellence – In addition to a differentiated and integrated customer experience, the Concentrix Health Practice clients are seeking to simplify and improve their internal operations, reduce costs and maximize the value of every customer interaction.

Concentrix Health Practice has been recognized for its market-leading services: In 2015, the company won the Innovator of the Year Award at a top 5 U.S. Health Plan’s Supplier Conference. Concentrix Health Practice is also part of the HfS Health Payer Operations 2015 Winners Circle. And in 2016, Concentrix’ Health Practice won a quality award competition from a top 3 U.S. Health Plan.

The company’s ability to leverage innovative technology, analytics, process optimization, and automation has earned national recognition—and driven innovative business improvements for a wide range of clients.



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