Collaborative Workflow for Health Plans

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Market forces are spurring health plans to offer new innovative products, improve the health of their members, improve quality of care and customer experience, and control rising medical costs.

To improve healthcare and trim medical costs, your employees must collaborate and streamline business processes across organizational boundaries. However, most people-driven processes within health plan organizations are manually intense and paper-based, making these processes ripe for automation. 

Microsoft solutions for collaborative workflows are based on Microsoft Office SharePoint Server offering health plan an integrated suite of server capabilities to automate and manage processes, content, insights, and collaboration within and beyond the enterprise. These solutions can accelerate the transformation of a health plan into a collaborative, information-driven enterprise focused on improving the health and experience of the consumer while holding medical costs down. Additionally, these solutions provide information and communications technology (ICT) professionals and developers the platform and tools they need for server administration, building composite applications, and interoperability. 

Manage people-driven processes and content

There are a number of processes within your organization that can benefit from these Microsoft solutions. These include sales proposal and request for proposal, policy and procedure life cycle, document management, care management, health assessments, referrals and authorizations, coordination of benefits, provider contracting, overpayment discovery and recovery, plan installation, and pay-for-performance and employer reporting. 

With SharePoint Server solutions you can streamline shared business processes through out-of-the-box workflows, easy-to-use electronic forms, and a simple, consistent user experience using familiar client applications. You can realize more value from information assets and simplify regulatory compliance by providing comprehensive control over the entire electronic content life cycle including contracts, documents, web pages, Portable Document Format (PDF) files, and email messages.

Connect people-driven and care processes to line-of-business applications

Microsoft solutions allow you to bridge the gaps between disparate applications and real-world business processes, connecting people and data to virtually any back-end application. For example, most claims processing systems don't fully support claims post-payment audit, discovery, and recovery processes. By leveraging the enterprise capabilities of SharePoint you can close these gaps while minimizing total cost of ownership. 

Browse claims details, even after post-payment audits.
 
 

Extend business processes across and beyond the organization

The extensibility of SharePoint Server allows you to leverage the efforts, innovation, and impact of employees, teams, brokers, providers, and partners. You can also help drive down operational and medical costs by managing the collaborative business and care processes with consumers, providers, brokers, and employers. For example, SharePoint Server makes it easier and less time-consuming for sales teams to collaboratively prepare a benefit plan proposal and deliver the proposal to agents and brokers, regardless of their location.

Centrally store, manage, and access documents across the enterprise

Microsoft solutions enable you to eliminate or improve inefficient manual information management by storing and organizing all business documents and content, such as policies, procedures, and credentialing, in one central location. Users have a consistent navigation mechanism that allows them to search for and find relevant information. Default repository settings can be modified to add workflow, define retention policies, audit access, and add new templates and content types as your business changes without requiring the involvement of additional IT resources. 

Improve your proposal and RFP process to reduce turnaround times and increase your win rate.
 

Improve business insight

You can turn information into action by delivering actionable insights and guidance within the context of the way your people and teams work internally and externally. Microsoft solutions help employees make better-informed decisions at all levels of your organization by efficiently finding, assembling, and analyzing critical business information from disparate sources such as documents, servers, line-of-business applications, databases, file shares, people, and SharePoint Server sites.

Share actionable insights broadly while helping to protect sensitive information

With Excel Services you can leverage the power of Microsoft Office Excel analysis capabilities against enterprise data, while benefiting from improved manageability of data, security, and the ability to reuse models through a scalable, server-based calculation service and interactive web-based user interface. Interactive spreadsheets can be incorporated into business intelligence portals, dashboards, and scorecards such as revenue cycle management, sales process optimization, product performance, and others. Data access can be secured at the server to help protect confidential information while maintaining the most up-to-date version of the information.

 

Provide centralized access to business-critical information

Gain and share insight by getting the right information to the right people at the right time by creating live, interactive business intelligence portals. By using the integrated business intelligence capabilities of SharePoint Server, such as dashboards, key performance indicators such as provider performance and critical claims processing metrics, and business data connectivity technologies, you can display critical business information from disparate sources in one comprehensive view.

 

View business information to help make informed decisions.
 
 

Simplify internal and external collaboration 

Share more information within and beyond the organization with less risk. By using the extensible policy management capabilities in SharePoint Server, you can seamlessly collaborate and share more information with external constituents with less risk. You can enhance protection against unauthorized access, usage, destruction, or loss of information by leveraging Information Rights Management, further reducing the complexities and risks related to privacy and security compliance. This gives you the confidence that information-use policies travel with the content no matter where it goes.
 

 

 

Enhance customer and partner relationships

With smart, standards-based, electronic forms–driven solutions, you can collect business information from customers and partners through a web browser, facilitating tighter connectivity with customers, partners, suppliers, and more. Integration with authentication sources in addition to Active Directory simplifies set up, improves security, and facilitates connecting to your partners, providers, and members.

Make it easier to search for information and people

SharePoint Enterprise Search incorporates people and profiles and business data along with documents, SharePoint Server sites, and web pages to provide more relevant and useful results. The Search Center provides a single integrated location for users to search for the resources they need. Alerts on search results notify users when new query matches are discovered. The results are filtered by the security model ensuring an efficient end-user experience. Content from outside the enterprise can easily be included to help significantly improve productivity. 

Personalize and customize the user experience with roles-based site templates

With SharePoint My Sites you can provide users with dedicated sites to store, present, view, and manage content, information, and applications in a controlled fashion. With My Sites, you can present information about the user, including skills, colleagues or managers, groups and distribution lists, or active documents. Stringent privacy controls and enhanced security mechanisms enable each user to choose how much information to present, and to whom. Roles-based templates for SharePoint My Sites make use of "out of the box" web parts, with no code, and provide a starting point for quick deployment of cost-effective and easy-to-use portals and dashboards that integrate with existing IT investments.

Work when and where you want

With offline access to SharePoint Server lists and document libraries, you can free yourself from the limitations of corporate network connectivity. Tight integration with Microsoft Office Groove further enhances the offline experience for your users.