Case Study: Visiting Nurse Service of New York (VNSNY) achieves faster, more secure appeals & grievances processing with Hyland OnBase

New York health plan enhances efficiency and security by automating appeals and grievances processes

VNSNY CHOICE, a not-for-profit New York health plan created by the Visiting Nurse Service of New York and serving about 48,500 members, struggled with slow, paper-based appeals and grievances (A&G) processes tracked in Access databases and Windows folders. Manual workflows led to lost documents, interrupted processing, poor turnaround times and regulatory reporting challenges.

In June 2016 VNSNY CHOICE deployed Hyland’s OnBase to automate A&G intake and case management: a third-party vendor categorizes incoming mail/email, staff vets entries, and OnBase auto-assigns cases, ingests membership data and populates response templates. The solution cut roughly 30 minutes per case, consolidated and secured A&G data, streamlined CMS reporting and dashboards, and set the stage for further integrations and automation.

Visiting Nurse Service of New York (VNSNY)

Tanya McCray

Vice President