Public Sector Case Studies

Health Solutions

Claims Processing

Public Sector 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.
Pre-authorization Application

Public Sector organizations use Haley to tell policy holders which treatments they are eligible to receive before treatment is provided. This service enables provides to rapidly convey accurate policy coverage information across multiple communication channels including web, automated phone response, and agent networks.

By using Haley solutions, you can:

  • Provide 24/7 automated, self-service pre-authorization guidance to policy holders improving quality of service and reducing customer and agent support costs.
  • Reduce cost of maintaining pre-authorization information against individual and group policy details.
  • Reduce probability of providing erroneous pre-authorization information to policy holders that result in subsequent claims dispute.
Benefits Explanation Application

Public Sector organizations are leveraging 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.
Process Management Application

Many organizations, departments, agencies, and integrators use Haley to improve process and program management capabilities.

Haley solutions can help you:

  • Standardize process and program implementation.
  • Standardize process and program management.
  • Reduce program and process implementation time.
  • Improve coordination between organizations, agencies, and departments.
  • Enhance ERP and supply chain application performance, while reducing operating costs.
  • Automate decision making in a dynamic environment where change is a constant due to operational and political diversions.
  • Speed time-to-decision making.
  • Improve asset and resource deployment.
  • Better leverage web and self-service technologies.
Document and Fulfillment Application

Federal, state, and Local agencies use Haley to improve their document fulfillment capabilities, improving constituent / customer service and reducing operating costs.

Haley solutions can help you:

  • Get the right piece of material, in the right hands, more quickly and efficiently.
  • Reduce the internal costs of managing documentation.
  • Manage and route requests at a more rapid rate to improve service levels.
Constituent / Customer Service Application

Federal, State, and Local agencies use Haley to reduce their operating expenses while providing better service. Haley's business rules enable agencies to provide the right information to constituents, streamlining service operations and improving service levels.

Haley solutions can help you:

  • Provide the right information to constituents in an automated fashion to streamline operations.
  • Improve satisfaction levels.
  • Reduce support and administrative costs.
Regulatory Compliance and Privacy Application

Federal, State, and Local agencies use Haley to improve regulatory enforcement and privacy initiatives. Using Haley Systems, agencies can minimize the total cost of managing regulations, improve their ability to identify cases of non-compliance, and enhance privacy.

Haley solutions can help you:

  • Ensure compliance programs are consistently applied and measured.
  • Improve privacy.
  • Reduce the cost of compliance monitoring.
  • Deploy changes to regulations and new regulations rapidly.
Benefits Explanation Application

Leading organizations are leveraging 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.