The ever-changing regulatory environment and consumer-centric Health Plans will only increase demand for exceptional customer service over time. Current and potential members will have a growing list of concerns as the industry continues to evolve, and they’ll expect you to be able to address those concerns promptly, accurately, and with the greatest possible level of convenience. Member enrollment, eligibility and billing must be timely, seamless, and cost-efficient for Health Plans to remain profitable and competitive.
Firstsource’s expert agents, leading-edge technology, and intelligent, automated solutions can take the stress out of some of the payer industry’s most crucial functions—enrolling and assisting members, monitoring and pursuing revenue, and managing interactions with government agencies regarding federal benefits.
Firstsource agents are specially trained and technologically equipped to manage inbound and outbound calls for new member enrollment, welcome calls, and customer service for your members.
Our secure, automated data management systems enable agents to process physical and electronic forms, make plan changes, explain benefits, and answer questions for new and existing members – even after hours and on weekends.
Firstsource’s billing and payment services are built around the specific needs of Health Plans to streamline revenue collection and prevent loss due to error and inefficiency.
Our automated technology, centralized data management, and deep industry knowledge enable us to effectively audit and analyze eligibility and benefits of members, along with billing and clinical documentation, to assess the accuracy of retrospective billing, reconcile reimbursements, and provide documentation enabling you to address discrepancies with minimal impact to provider relationships.
Our fully integrated system can reconcile billing with revenue reports and identify potential sources of loss in the future.
Firstsource’s Medicare and Medicaid resources can help establish your company as a source of information and guidance in increasingly complex times.
Our specialized agents are trained and experienced with the intricacies and specific requirements associated with federal health benefits. By screening members’ eligibility, we ensure members are receiving the coverage they need while minimizing improper payments and, when applicable, assist eligible members with a smooth conversion into the appropriate programs.
A multi-state US Health Plan was able to maintain inventory, meet regulatory turnaround times, and maintain membership for about a million members as its marketplace membership increased 40-50% per year in the first two years under the Affordable Care Act (ACA).
Our clients include 12 of the top 20 Health Plans nationwide
Our solutions are backed by Robotic Process Automation, advanced analytics and more
With our 20+ years' experience in the field, you'll know your customers are in good hands