Transforming the way you manage critical compliance processes with better efficiency, transparency and outcomes
Struggling to meet deadlines for appeals and grievances? With a 24- to 72-hour turn around time in some cases, manual processes can really slow you down. CODY® has a solution for you.
Managed care plans must follow strict rules for how they identify, track, and report all appeals and grievances. Even after a decision is made, additional steps remain in the process: member notification; additional levels of appeal; and aggregate reporting with trends identified and addressed.
Created just for you by the people who understand the challenges
facing Appeals and Grievances, Operations and Compliance, we've built a robust solution with the following features and capabilities:
- Easy systems integration
- Dashboards, pre-built and custom reports, and monitoring
- Automated CMS audit universes
- Integration with CODY® HPMS Memo Module®
- Root cause analysis and trending
- Automated letter generation
- Data validation and data integrity rules
- Comprehensive quality review process
- Workflow and audit trail
- Case completion and effectuation rules
- IRE packet automation
The CodySoft® Appeals and Grievances Module® addresses the administrative complexity of the process from intake to aggregate outcome reporting; eliminating manual and inefficient activity, reducing case errors and missed deadlines, and improving compliance.