Case Study: Fortune 500 Healthcare Company achieves automated, compliant Appeals and Grievances processing and faster resolutions with Newgen Software

Fortune 500 Healthcare Payer automates Appeals and Grievances process with Newgen's solution

A Fortune 500, multi-state healthcare payer offering Medicare and Medicaid faced inefficient, manual Appeals & Grievances processes—no centralized repository, no automated correspondence, poor duplicate-case validation, limited tracking and long turnaround times that risked non‑compliance. The payer selected Newgen for its expertise in BPM, ECM and CCM to streamline and automate the process.

Newgen deployed an integrated BPM and ECM-based Appeals & Grievances solution that digitized documents, automated workflows, auto‑assigned cases from multiple intake channels, generated correspondence from templates, and provided real‑time monitoring, alerts and audit trails. The solution reduced manual handoffs and data-entry errors, improved SLA compliance and document retrieval, shortened turnaround times and boosted member satisfaction.