Enhance provider experience with EXL’s data-led, digital provider portal and automated calling platform

Healthcare providers that rely on traditional methods for medical record submission like mail, copies, faxes, and other methods for medical record (MR) submission are losing potential revenue opportunities while placing valuable-payer partnership at risk. Manual processes are slow to complete and prone to error, as they require high levels of rework and often end up with records lost within the submission workflow due to miscommunication on status and missing receipts between the stakeholders (submitters, processors, and receivers).

When facing high volumes, manual submission processes can become even more unmanageable. Capacity limitations can strain the ability of support staff to route the MR to the respective auditors efficiently and effectively. When further burdened by internal silos, an overdependence on single-mode communications, and data gaps created by disparate software and reporting systems, the entire MR submission for prepay and post-pay audit cycle becomes untenable.

This is where EXL’s automated provider communications can make a stark difference.

Alleviate friction with an end-to-end digital support solution

EXL’s automated provider communications represents an end-to-end digital support solution that streamlines MR submission, vendor/provider communications, operational workflows, and associated support services. This holistic solution represents two integrated components:

  • EXL’s Digital Provider Portal – Enables 24/7 MR submission online and provides updates on the status of submitted MRs, as well as other self-service capabilities for support requests
  • EXL’s Provider Calling Platform – Combines live, integrated inbound call management and support to accelerate query resolution

Our self-service provider web portal with intelligent calling solutions and backend data stores creates a user-friendly experience that reduces intake errors, provider abrasion, and cuts call handling and turnaround times at a significant cost savings.

How our integrated, data-led solution works

EXL’s holistic provider solution features a web-based application designed to serve as an automated transom for multi-channel MR-related communications between payers and providers, backed by an inbound calling platform that supports live agent interactions with integrated chatbot, texting, and email capabilities.

The system is powered by a sophisticated rules-based engine customized to enforce the unique prioritization framework of any provider organization. EXL’s dedicated team of MR intake professionals curates all data in ready-to-use formats, and can assist on demand through digital means to keep the process flowing.

Any authenticated user may access the secure web portal at any time to log in and upload MRs, place inquiries, access automated chat support, make basic changes, and check on the status of audits, appeals, and other claims-related initiatives – without the need for human assistance. The platform unifies email, fax, voicemail, and helpline interactions automatically. Because the portal is connected to all data sources associated with the MR process, interactions that do require human intervention can be automatically routed to the appropriate team members with all relevant details attached for prompt, efficient response.

A digital toolbox for data-led value creation

EXL’s provider communications solution includes a full set of digital, purpose-built tools to support and expedite MR submission for maximum value. These include:

  • Chatbots to provide a world-class, self-service support experience for frequent requests, with response capabilities across a variety of communications channels.
  • Intelligent calling solution anchored by a self-service IVR system for handling incoming calls based on standard queries.
  • Automated quality control process for testing incoming lines, including voicemails, fax, and emails, ensuring all lines are working and open to satisfactory levels.
  • Unified email, fax, and voicemail over a secure web portal that integrates all modes of inquiry for efficient tracking and support.
  • QR codes for MR requests encouraging digital engagement rather than using manual touchpoints for optimum real-time convenience by automating receipt and routing of MR to the downstream process
  • Integrated automation for scheduled delivery of demand documents in various modes in near real time.
  • End-to-end prioritization framework customized per organization for handling queries according to SLAs that maximize business benefits and reduce provider abrasion.
  • Integrated real-time dashboard for user-friendly tracking of incoming and outgoing calls and requests from a single screen.
  • Improved provider experience through prompt, accurate auto-acknowledgement on queries received via voicemails, emails, and fax, thereby reducing the number of additional inquiries and improving user confidence in the system.

Improve your claims resolution experience

  • Reduce the number of complaints in the MR submission process
  • Enhance partner relations through early detection of issues
  • Create a superior payer/provider experience through self-service automation
  • Shorten turnaround times using efficient, optimized business workflows

EXL’s automated provider communications platform can benefit you

Efficiency gains through digital MR submission on integrated platform

Assurance of customer and provider interaction with improved CX

Efficiency gains by reducing average call-handling times

Cost savings by automated processes and chatbots

Reduced turn-around time in handling provider queries and follow-ups