Resolve members’ appeals and grievances while complying with regulatory guidelines and adhering to state-level and CMS (Centre for Medicare and Medicaid Services) guidelines. Optimize resources and reduce turnaround times by leveraging our rule-driven engine to prioritize and route all service requests. Capture all decisions, notes, and exceptions within the system for future reference and audits. Automate your service requests processes to future-proof your organization, stay on top of regulations, and guarantee member satisfaction.