New Abilities for Care-Oriented Customer Service

Episodes of Care
Providing a platform that enhances the health of the employees, members, and families we serve is Beacon’s highest goal. The ability to track, monitor, and log key conditions is the first step in the process; identifying the onset and costs of necessary conditions in the populations for which we manage claims. Beacon has developed new care-oriented customer service technology within the SpyGlass suite that allows you to define specific conditions that you need to monitor within your population. Once defined, the impact of these conditions are visible in the member portion. This allows your customer service team to see which members/dependents have special conditions and help them avoid the “red zone.” Your customer service and wellness teams can get all the necessary information to evaluate the scope of the issues before them.

Further, SpyGlass’ new value-based benefit related customer service alert and trigger features allow you to help members keep ahead of additional unseen conditions, and reward them when they do. Once these incentive-oriented compliance triggers have been established, SpyGlass provides updates as members meet the goals you’ve put in place. As members meet the special objectives established by a healthcare plan, you’ll be able to positively impact the out-of-pocket costs of your members and their dependents.

Altogether, these capabilities in SpyGlass allow healthcare payers track, log, and monitor:

  • Conditions of patients

  • Accumulated totals for their conditions, tracking actual contributing claims

  • Compliance of members and patients towards achieving value-based benefits

  • Improved individual benefit out-of-pocket costs through compliance

These new structures, in combination with SpyGlass’ value-based benefit solutions, will facilitate stronger and positive relationships with members and in turn, engage members in their personal care. This might make the differences for you as you help your population.

See How Beacon Can Help Your Company

Give Beacon the opportunity to show you how the SpyGlass suite will improve auto-adjudication rates, claim payment accuracy, and allow you to devote your time away from manual review to more strategic efforts.