Managed Health Care
Complaint Handling

Managed Health Care - Appeals and Grievances

Streamline your complaint handling process with Everest.  An efficient workflow will help to track every step for an expedited resolution to complaints, appeals and grievances.  Everest will become the center piece for building lasting member relationships. 

Effectively handling of customer concerns is critical to a well run organization. When customers are satisfied with the way their complaint is handled, they are likely to become long term loyal customers. Companies that resolve complaints on the first contact increase customer satisfaction and product loyalty, improve employee satisfaction, and reduce costs.

Complaints are a gift; the Everest approach encourges customers to express their concerns. By making it easy for customers to complain, more customers will come forward with their problems, giving you greater opportunity to improve your service. On average, satisfied customers share their experience with five or more friends while dissatisfied customer share their experience with twenty or more friends. The best investment an organization can make is to resolve customer concerns quickly and thouroughly.

Quickly analyze and share critical information with powerful reports and charts. Sort and filter organized reports in seconds and e-mail directly from Everest. A user friendly query builder allows you to create custom reports including any field in the database.

Easily control access through user group controls that are tied to the users ID and Password. Set rules for password size and expiration time. A complete Audit Report is available to review every add, change and delete.

Best Practices in Managed Health Care

  • A complaints management system needs to provide a consumer focused approach.
  • Complaints are logged and classified for resolution and documenting.
  • Complaint are assigned to one owner while incorporating feedback from others to achieve a comprehensive resolution.
  • Customers need convenient methods to report complaints and must be encouraged to voice their dissatisfaction.
  • Ensures adherence and compliance to regulatory requirements.
  • Reduces cycle times through optimized routing of work and reduction of manual processes to document and resolve issues.
  • Provides insight into the effectiveness of business processes through comprehensive trend analysis.