Business Process Outsourcing Engagement Solutions
At NationsHealth, we specialize in improving healthcare outcomes
through industry leading, scalable and flexible solutions. While
traditional BPOs tend to manage a wide variety of outsourcing areas
- we are focused on the healthcare industry - and specifically in
driving the right outcomes for patients with chronic conditions.
This helps you manage chronic illness, drive quality (HEDIS and
Five-Star), and more efficiently manage specific areas of your
business such as Medicare Parts B and D.
With our on-shore and off-shore locations, we will be
able to customize an outsourcing model to precisely meet your
needs. We provide:
Medicare Part D BPO Services
Licensed Insurance
Agents
- Year-round enrollment activities
- Medicare Annual Election Period (AEP) enrollment
- Insurance broker outreach
- Retention
Unlicensed
Representatives
- Year-round member service
- Outbound education and verification
- Customer satisfaction surveys
- Plan change services
Flexible
Technology
- Innovative healthcare IT platform
- Robust reporting and analytics capabilities
- Eligibility management
- Enrollment / disenrollment management
- Premium billing and collections
- Member mail management
- Fulfillment services
- Document reconciliation and management
- Three-way reconciliation (CMS, fiduciary, PBM)
- PBM integration
- EGWP development available
Healthcare BPO Services
Member Engagement Center
Services
- Clinical and non-clinical staffing
- Clinical and non-clinical rollover capacity
- Inbound / outbound engagement services
- Physician and insurance broker outreach
- On-shore and off-shore agent options
- Survey capabilities for satisfaction measurement as well as
clinical data gathering (Five-Star and HEDIS support)
- Inbound / outbound provider engagement
- Compliance and audit services
- Health education, reminders and reporting
- Flexible thin client IT environment with robust reporting
capabilities
- Automated call processing (IVR)
- Print and email campaigns
- Internet landing pages for information capture and educational
content delivery
Medical Product Services
Fulfillment
Services
- Fulfillment and distribution services (i.e. diabetes,
respiratory, ostomy and urological)
- Specialty pharmaceutical mail order delivery program - with
deep Part B experience
- Formulary development assistance
- Physician outreach
- Retail to mail conversion
Over-the-counter
(OTC)
- Over-the-counter (OTC) product distribution and benefit
administration
- Development of CMS compliant catalogs and literature
- Custom and special products
Part B
Conversion
- Conversion of self-funded employer retirees to part B for
diabetic and respiratory supplies
Distribution Engagement
Services
- Proactive patient outreach to educate and encourage compliance
with physician orders
-
- Average telephonic patient outreach frequency of four times per
year
- Hassle Free Healthy Living program
educational literature and tools delivered to patients / members as
part of our mail order supply program
- We do not compete in the prescription drug space
- Medical billing and compliance infrastructure to mitigate
risk
We deliver these
strategic advantages:
- Outstanding reliability, scalability, and flexibility of
healthcare contact services
- Multiple locations to mitigate service disruptions caused by
weather or other unforeseen circumstances
- Capacity scaling expertise to allow for fast response to
unexpectedly large call volume
- Multi-lingual services
- Blended on- and off-shore solutions
Reorder Your Diabetes Supplies
"We’re not just focused on outreach, we’re driving outcomes."