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Like most customer-focused industries, Health Insurance companies are evaluating strategic sourcing alternatives that will allow them to better control costs, reduce capital expenditures and improve the level of service they deliver to their members. One way Health Insurance companies can accomplish these objectives is to consider selective Business Process Outsourcing (BPO) for certain sales, customer service, claims management and back-office processing functions.

With over two decades in the outsourcing services arena, Sutherland has developed a time-tested outsourcing model that delivers measurable results for insurance clients - whether it is converting marketing inquiries into closed sales, improving customer satisfaction scores or reducing administrative costs for manual, paper-intensive processes.

Sutherland’s outsourcing services for the Health Insurance industry fall into the following categories:

Member Acquisition Member Care Provider Care Back-Office
Sales and marketing such as:

• Inbound telemarketing
• Outbound telemarketing
• Online sales assistance
• Quoting
• Lead generation
• Direct response programs
• Enrollment inquiries
Member inquiries relating to:

• Coverage
• Claims
• Coordination of Benefits
• PCP
• Emergency/Urgent Care
• Referrals
• ID Cards
• Prescriptions
Provider inquiries relating to:

• Eligibility
• Copays/limits/deductibles
• Patient information
• Coverage
• Referral requests
• Policies/procedures
• Plans and products
• Health & wellness
Non-voice processing such as:

• Claims data entry
• Edits/exception    corrections
• Enrollment processing
• Account payable
• Accounts receivables

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