Allowing health plans to streamline costs and operations to focus on what they do best—improving healthcare outcomes
– Specialized in health plans with broad and deep industry experience
– Diversity-certified, woman-owned business
– US based
– Providing world class service to your customers
Catalyst provides complete call center outsourcing and consulting on behalf of health plans
Catalyst brings a deep and broad blend of industry expertise, technical knowledge and optimization methodologies that work together to deliver a superior outcome. We pride ourselves in providing world class service with our US based operations. Catalyst takes a unique approach to transforming the way it partners with healthcare plans to maximize call center performance, with a focus on driving positive change.
We even have a financially based performance guarantee!
Overflow outsourcing to manage call volume surges–
Ensure every caller reaches a real agent and customer service levels are maintained, while reducing stress placed on existing call center agents. When the pre-established threshold is reached, service delays can be eliminated by seamlessly triggering calls to forward to Catalyst agents.
Medicaid, Medicare and Medicare Advantage Specialized Services–
There are nuances to servicing this membership that may not exist with other types of plans. Catalyst specializes in ensuring the highest level of service catered to these members, including a white glove service, plus compliance and audit services. There are nuances to servicing this membership that may not exist with other types of plans. Catalyst specializes in ensuring the highest level of service catered to these members, including a white glove service, plus compliance and audit services.
Campaign-based outsourcing–
Catalyst leads communication campaigns that inform or influence behaviors in large audiences within a specified period using multiple channels to drive healthcare outcomes. For example, Catalyst can help with vaccination campaigns (Covid and flu shots), as well as campaigns related to chronic conditions.
SERVICES
Primary Call Center Services
• Intake channels
– Telephone
– IVR
– Portal (webchat/app chat)
• Outbound channels
– Telephone
– SMS
• Appeals/grievances contact intake
• Outbound campaigns
• Benefit verification
• Medical management
• Eligibility verification
• Claims status verification
• Utilization management status verification
• ID card request/fulfillment requests
• Member demographic updates
• PCP assignment and updates
• Correspondence reissues
• Pre-enrollment calls
• Issue tracking and resolution
Ancillary Call Center Services
• Call center audit
• Training
• Process documentation
• Metrics and reporting
• Consulting: Call center optimization
• Consulting: Technology integration
TECHNOLOGY
Telephony
• ACD/PBX
• Call recording
• Softphone
• SIP trunk
• IVR
• Workforce management
• SMS messaging
• Live chat
• Chat
Workflow
• Human workflow
• Task management
Self Service
• Member
• Provider
• Agent
• Broker
• Enrollment
• Appeals/grievances
Why choose Catalyst Solution’s Claims administration and consulting services?
Given the importance of claims administration, many insurance providers are choosing to outsource the process of claims administration to specialized experts like Catalyst Solutions. Catalyst aligns our outsourcing and consulting services to your business goals and uses our health plan industry expertise to anticipate your long-term needs. Our services don’t end with outsourcing. We become your trusted advisor and collaborate with you in achieving a better future.
Catalyst believes true success in a BPO relationship can only be built on collaborative partnerships. Our mission is to extend our competencies and scalability to help your health plan focus on what really matters, so much so, that we are willing to build financially based service level agreements into our contracts. This means we put our skin in the game. Together we share both risk and reward.
Learn more about why outsourcing claims administration makes good business sense.
