Member Grievances & Appeals

Streamline grievance & appeals processes to drive operational efficiencies and member satisfaction.

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Unqork empowers payers to rapidly build and effectively manage a robust grievances & appeals solution. With Unqork, organizations can seamlessly integrate any solution with existing internal systems and, if necessary, external third-party services. Members can submit complaints, appeals, and relevant documentation through a patient facing digital hub, which they can access at any time for up-to-date claim status.

With a centralized system, data collection and formatting can be standardized across the process for improved analysis, reporting, and case reviews. Custom rules can be applied at scale to automatically classify cases or issues and funnel them into the appropriate workflows. The solution can be designed to auto-generate personalized member communications such as status updates or calls to action (e.g., a need to submit additional information relevant to the case).

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Increased member satisfaction

Accelerate resolutions and provide better visibility

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Improved operational efficiencies

Streamline processes and free-up capacity for mission-critical or high-touch processes

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Rock-solid compliance

Easily update workflows to ensure processes are in regulatory good standing

Featured Content

How No-Code Accelerates Digital Transformation in Healthcare for Payers

Learn why leading companies are increasingly embracing Unqork's no-code development platform to address rising member expectations for on demand services, and accelerate the building of scalable, sophisticated solutions.

read the ebook

Additional Capabilities

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Seamless Integrations

Integrate with existing systems and external services

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Document Management

Generate, manage and store relevant documents

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Data-Powered Analytics

Identify bottlenecks to improve processes over time

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Member-Facing Hub

Provide members with an omnichannel hub to submit claims & documents, and to view up-to-date claim status

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Configurable Automation

Execute high-volume tasks with machine efficiency to expedite processes and reduce costs

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Compliance Reporting

Auto-generated compliance reports will support robust compliance capabilities

Featured Content

Infographic: The Unqork Impact

Check out the following infographic to see how leading organizations from across various industries are accelerating their digital transformation efforts using Unqork.

See the Infographic

Contact us to learn more

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