Overview

We have health plan DNA. Over the years we’ve launched hundreds of projects touching almost every area: sales, enrollment, customer service, claims, care management, credentialing, and a variety of ancillary processes.

Highly skilled resources and rapid deployment were foundational to our model. But since we’ve always held ourselves accountable for delivering not just great people, but great results, our clients trust us with their mission-critical projects, core processes and valued customer relationships.

Sales and Marketing

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TeleSales

With expertise in both under 65 and Medicare programs, we drive exceptional conversion rates while maintaining a high standard of compliance. We also quickly adapt to unforeseen spikes so your customers get the same excellent service regardless of demand.

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Field Sales

Our experienced, licensed field agents provide flexible territory coverage and support multiple venues, including retail, in-home, kiosk, or sales seminars. Operating independently or integrated into your team, we strive to create remarkable prospect interactions that enhance and promote your brand.

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Marketing

We help you design and execute customized and  targeted multi-channel campaigns supported by our robust marketing automation and CRM solution. And since our contact center is fully integrated with this platform, we can manage the entire sales lifecycle on a turn-key basis

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Customer Care

Our contact centers feature robust, secure, feature-rich and scalable technology. We can support multiple channels including voice, chat, email, social media, and mobile and can handle inbound, outbound, or blended approaches. Most importantly, our seasoned agents, with both functional and system-specific expertise, will provide a superior member or provider experience to solidify your position as a market leader.

Member Services

It costs a lot more to acquire a new customer than to retain an existing one. We view each call as an opportunity to drive loyalty and retention, and our focus is on engaging, personalized communications that enrich each member’s perception of your brand. Our agents are highly trained on your products, messaging, and culture to deliver a customer experience on par with your best associates.

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Provider Services

In the quest for growth, provider interactions are often overlooked. Consolidation, narrow networks, and other forces are causing health plans to reconsider this approach. With a workforce of highly experienced agents and an advanced contact center platform, we can deliver best-in-class customer service to meaningfully enhance your provider relationships.

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Claims

Turn to us for the complex work. We have deep expertise managing specialized claim processes in all lines of business. We can work on your platform or ours. And we can deliver where and when you need it – managed services, surge projects, or overflow support.

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  • Processing
  • Adjustments
  • Recoveries & COB
  • Medical Review
  • Appeals & Grievances
  • Audit & QA
  • Data Mining & Pricing
  • Research & testing

Administration

 

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Provider Credentialing

If you are expanding the  network or backlogged with credentialing work, consider engaging with us. Our professionals have years of experience with the provider verification process. Once we are trained on your systems and procedures we will match or exceed production and quality standards to get you where you need to be.

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Provider Data Updates

Keeping provider data current is a constant challenge for health plans. Despite the best efforts at automation sometimes manual intervention is your only choice. When it comes to that, we can help. Our specialized teams can perform outbound queries, web research, database research, even claims processing if necessary.

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Enrollment Support

Both Medicare and exchange enrollment transactions can be plagued by inaccuracies and incomplete data. These issues create problems throughout the organization and frustrate new members. We can provide: enrollment processing; weekly and monthly TRR reconciliation; 834 audits and reconciliation

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HICS Support

The Health Insurance Casework System (HICS) is an administrative requirement that many plans are challenged to keep up with. As CMS begins to phase in penalties for not meeting turnaround times, HICS cases will be even more important to stay on top of. We can provide a project-based or fully outsourced solution for timely resolution of both Level 1 and 2 cases.

Medicare Contracting

BroadPath is the premier national provider of specialized surge and bridge support to Medicare Administrative Contractors (MACs) and other CMS prime contractors. If you are taking over a new jurisdiction, winding down a contract, responding to a CMS Change Request (CR), or simply experiencing higher than expected workload, we can help. Our highly experienced resources and consultants can be delivered in a variety of service levels ranging from simple workforce augmentation to fully-outsourced solutions.

Areas we Support Include:

  • Provider Enrollment & Revalidation
  • Provider Enrollment Customer Service
  • Part A & B Appeals (reopenings & redeterminations)
  • Nurse Medical Review
  • Recoveries/COB Support
  • Training

 

Consulting

Our network of knowledge runs broad and deep. With expertise in sales, marketing, customer care, plan administration, and compliance our consultants help design strategy, develop marketing campaigns, analyze customer data, evaluate and refine business processes, and assess regulatory risks.

HIPAA Compliance

Our risk assessments and compliance audits assess your administrative, physical, and technical safeguards to ensure the confidentiality, integrity, and availability of PHI. We also outline priorities for mitigation so you can quickly close the gaps.

System Testing & Configuration

We can provide the technical and operational expertise to help support your core claims and administrative systems. With hands on user experience on all the major platforms we can offer practical advice and objective guidance – before, during, and after implementation.

ICD-10 Support

We analyze your organization for ICD-10 risks and opportunities, developing a best practices approach to facilitate a smooth transition. We can assist with project management, training, testing, mitigation, and financial planning.

CRM Development

Our certified force.com developers have extensive experience automating health plan sales and marketing processes and can build just about any custom application imaginable. Responsible for the maintenance of our Medicare 360™ and HIX 360™ platforms, they can also provide seamless integration with your core administrative systems.

Get started today.

Find out what BroadPath can do for your organization.

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