Take control of your Grievances Management Program
Manage and Resolve Member Grievances Efficiently
GrievancesHub presents a web-based resolution system that offers Health Plans and PBMs a comprehensive platform to manage and resolve member grievances efficiently, while also ensuring compliance with CMS requirements. Constructed to meet the specific requirements of health plans and pharmacy benefit managers (PBMs) within Medicare and commercial plan domains, this solution extends to cover Medicaid and ACA programs as well. Below are some of the key features that highlight the capabilities of GrievancesHub.
Streamline grievance management with GrievancesHub’s centralized system. Efficiently log and monitor member complaints to ensure timely resolution and improved member satisfaction.
Customizable Turnaround Times
Tailor the grievance resolution process to your specific needs. Set internal deadlines and adjust timelines to meet CMS requirements to optimize efficiency and compliance.
Robust Reporting Capabilities
Gain valuable insights with GrievancesHub’s comprehensive reporting features. Access CMS required reports for audits and monitor productivity effortlessly with standard and customizable reporting options.
Enhance the member experience through seamless integration. Facilitate electronic delivery of communications to members to ensure secure and timely access to crucial grievance-related information.
GrievancesHub provides role-based access, allowing different users to perform specific functions based on their roles. The system offers roles such as triage, caseworker, manager, and admin, ensuring appropriate access and data security.
The solution houses letter templates that are used to respond to grievances. Admins and managers can upload and manage letter templates, while caseworkers can use them to generate responses for specific cases.
The system aims to incorporate intelligent automation to streamline processes further. For instance, it can automatically dismiss cases that fall outside the CMS-mandated timeline, reducing manual intervention.
GrievancesHub offers a well-defined workflow, ensuring that cases are appropriately handled. It allows for case escalation to managers when needed and facilitates effective communication within the team.
The system is designed to cater to the specific needs of health plans and PBMs. It recognizes the unique requirements of each client and can be customized accordingly to align with their internal processes and preferences.
Comprehensive Training & Support
Agadia provides comprehensive training and support to clients during the implementation phase and beyond. This ensures smooth adoption and optimal utilization of GrievancesHub.