Healthcare Solutions

Claims Processing

Organizations leverage Haley to reduce claim leakage, claims operations costs, and provide timely and high quality policy holder service.

Haley solutions can help you:

• Increase your claims adjudication STP percentage reducing operating costs and improving timeliness of claim response.
• Apply consistent decision making across claims function reducing leakage and improving quality of response.
• Make changes more rapidly to claims policies and rules reflecting latest corporate-wide learnings.
• Rapidly and thoroughly detect claim fraud patterns.

Benefits Explanation Application

Organizations leverage Haley to clearly illustrate to policy holders and insurance administrators the benefits contained in their policies. In doing so, Insurance providers can increase customer satisfaction and improve sales and operating efficiency across both captive and indirect channels.

Haley solutions can help you:

• Illustrate and change policy and benefits easily across multiple channels simultaneously to facilitate sales and delivery operations.
• Automate responses to customer policy questions to decrease response time and improve response accuracy.

CRM / Customer Service Application

Organizations use Haley to improve their CRM / Customer Service capabilities and performance.

Haley solutions can help you:

• Make the promises of CRM deployment and usage a reality.
• Improve account planning and business development efforts.
• Segment customers and prospects at a highly detailed level to determine the optimal solution and sales approach.
• Provide sales / account management professionals with the right intelligence and insight to improve their effectiveness.
• Provide a better customer experience.
• Speed time-to-decision making.
• Improve asset and resource deployment.

Customer Self-Service / Configuration Application

Organizations use Haley to improve customer self-service, configuration, and order management capabilities, reducing operating expenses while providing better customer service.

Haley solutions can help you:

• Provide the right information to customers (public and private sector) in an automated fashion to streamline operations.
• Improve customer satisfaction.
• Reduce customer support and administrative costs.
• Reduce errors

Knowledge Capture, Sharing, and Reuse Application

Organizations use Haley to improve knowledge capture, sharing, and reuse.

Haley solutions can help you:

• Address aging workforce by capturing knowledge
• Avoid labor and skills shortages.
• Capture and deploy best practices and processes across internal and extended teams and organizations.
• Standardize and institutionalize knowledge and processes.
• Avoid sanctions and fines for improper processes.
• Improve operational capability and efficiency.

Operational Efficiency / Cost Reduction Application

Organizations use Haley to improve knowledge capture, sharing, and reuse.

Haley solutions can help you:

• Standardize processes and procedures to drive operational efficiency and cost reduction efforts.
• Reduce and extend IT headcount.
• Reduce systems costs (packaged, legacy, etc.).
• Take corrective action based on operational performance indicators.
• Tie cost reduction efforts to business process improvement.
• Align and measure IT and business initiatives.

Billing Operations Application

Organizations use Haley to enhance their billing operations capabilities and to improve accuracy, customer service, and internal operating efficiency.

Haley solutions can help you:

• More rapidly process accounts to improve cash flow and reduce overall billing costs.
• Reduce operating costs while increasing the billing speed by realizing higher Straight through Processing (STP) percentage.
• Enable consistent decision making rules to leverage expertise and knowledge to reduce billing errors.
• Make billing policy changes more rapidly across your entire organization.