Incident and Case Management

The Health Insurance industry or the health payers are subjected to incidents that occur from deliberate human actions such as fraudulent claims and information security breaches. There are other incidents such as customer grievances, unethical practices and so on.

MetricStream solution for Incident and Case Management is a comprehensive solution that enables the health payer to establish and follow consistent procedures for incident capture, exception logging, loss event tracking, task management and status reporting. Built on a centralized platform, the incident management solution extends across the enterprise, consolidating all incidents in a single point of reference. It also streamlines and standardizes the development and implementation of enterprise-wide remediation and corrective action plans.

Powerful dashboards provide real-time visibility that help health plan providers track each incident through its lifecycle from initiation to closure - following the appropriate processes to ensure that nothing slips through the cracks. In addition, an advanced analytics and reporting capability helps managers perform a trend analysis, spot recurring problems, and identify their root cause in a timely manner.

Downloads

• Solution Brief: Incident and Case Management
• Case Study: A Leading Health Insurance Provider Strengthens Compliance Management

Featured

Press Release:
The Federal Home Loan Bank of Chicago Goes Live with MetricStream Solutions for Compliance, Audit and Issue Management

Analyst Research

Access a complimentary copy of Gartner Magic Quadrant for Enterprise Governance, Risk & Compliance Platforms, 2011 to get an up-to-date view of the GRC platform landscape.
July 2011 | Read Report

Download a complimentary copy of The Forrester Wave™: Enterprise Governance, Risk, And Compliance Platforms, Q4 2011

November 2011 | Download Report