powering the future of health care together

Partner With Proven Experience: HM Health Solutions

Enterprise Health Solution

Customer Service


The Enterprise Health Solution is a comprehensive and integrated health-plan-operations solution that combines a technical platform, best-in-class processes, and consultation from knowledgeable experts all to make it possible for health-plan partners to effectively run their own businesses. Within the Enterprise Health Solution is the Customer Service Product. With this product, and its supporting tools, health-plan partners handle their customer-service inquiries with a high level of integration and ease. The tools are so intuitive. It's such a great fit for our work process.

With a tightly scripted authentication process that meets strict privacy requirements, the customer-service tool supplies a health plan's customer service representative, or CSR, with the questions that must be asked in order, helping her power through the workflow. A visible red diamond may let the CSR know what data can't be shared, and flag alerts signal interactive notifications in real time as data is collected. The tool is easy to use and follow. We feel confident that our CSRs are working through the important details.

The Customer Service tool is a process-driven technology that intuitively guides the health-plan CSR through an interaction, giving her the available information she needs when she needs it. Issues can be quickly added to a running to-do list so CSRs can prevent items from getting lost or forgotten. Items can also be assigned to others for parallel processing. With guided help from the tool, we can pay more attention to the member and less time worrying if we've forgotten something.

The Customer Service tool allows the health-plan CSR to quickly send replies by e-mail, letter, or via the integrated Message Center using prepared templates without ever having to leave her desk. And the dashboard within the tool gives managers an easy way to monitor and manage their team's workflow and to assign work by skill. We have what we need at our fingertips, which means we can feel confident that our team is on the right track.

The Enterprise Health Solution gives health-plan partners tools to improve their own outcomes and efficiency. Powering the future of healthcare together.

Business Solutions

Enterprise Health Solution

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