Payer
Create a seamless engagement experience that delights every stakeholder
Payers fight a never-ending battle to effectively manage relationships with the provider, group, and member communities — in addition to traditional operational challenges like claims processing times and aging technology. But now, they must also face new demands such as the never-ending stream of government regulations and demands to lower costs in the healthcare delivery chain.
How can payers keep up? By maximizing every stakeholder interaction with an integrated solution for operational processes and technologies. Moreover, by ensuring that these solutions are tailored to individual needs and easy for patients to navigate. Exceptional patient experiences, powered by state-of-the-art technology, increase member satisfaction, retention, and brand loyalty.
The Silverline Difference
Current technologies provide fragmented solutions to payers. Some of these solutions excel at processing claims but create a poor experience for servicing members. Others patch together systems that struggle to create a seamless experience for the payer user community. Systems don’t always communicate, such as a sales solution that doesn’t integrate with a membership system. This results in a poor experience for all payer team members, group administrators, and members.
Silverline provides a delightful and connected experience across all areas in a payer organization.
Built on Salesforce technologies, Silverline enables six key capabilities for health insurance organizations.
Attract
Entice new groups and individuals to a payer’s suite of products through marketing outreach campaigns. Create specialized campaigns that communicate the payer’s message to the right audience (individuals, group administrators, brokers) via the most appropriate communication channel for that audience. Silverline helps payers guide members, group administrators, or business development teams with a more seamless customer experience.
Acquire
Streamline product selection and enrollment processes to acquire new customers. With Silverline’s guidance, payers can help new customers select the products that best suit their needs. This capability makes the enrollment process much easier for brokers, business developers, underwriters, and membership team members. Keep these customers year after year with support for a renewal process that quickly re-enrolls members into existing or new products offered by the payer.
Administer
Respond to changing needs of members and groups over the life of a plan. Silverline helps payers administer the contractual features of the plan, like billing, while helping the payer react to group and life changes experienced by the member population.
With Salesforce, you can keep health insurance data all in one place, so if claims or eligibility disputes arise, Grievances and Appeals teams have everything they need to adjudicate their cases.
Care Management
Take an active role in member health. Whether it is helping a member maintain their disease management program or providing answers to member-submitted health questions, effective care management is crucial to the successful relationship between the payers and their member and group communities.
Our Salesforce implementations are designed to help you identify gaps in care, create health maintenance programs, and monitor the adherence to these programs. Using the same tools as those for marketing outreach, payers can create a journey for their members that improves their health, manage specific conditions, or support them on their health journey.
Intelligent Insights
Manage every area of the business with intelligent insights all in one place. Make data-driven decisions by looking at new and existing market opportunities, addressing gaps in care when creating care management plans, or identifying key utilization trends.
360 Degree View
See exactly what’s happening with members, from the very beginning of their relationship with the payer. Silverline provides payers with the tools necessary to assist the Member Services team with any inquiry by members, group administrators, or providers.
Digital transformation powered by Vlocity and Silverline
Members today expect a more connected, personalized experience. For payers, Vlocity delivers industry-specific cloud and mobile software that embed digital, omnichannel processes — enabling experiences that better serve members and member relations team members. As one of Vlocity’s strongest partners in Property & Casualty, Health, and Life & Annuity Insurance for the last two years, we can help enable your transformation by leveraging industry-leading Vlocity solutions on the Salesforce platform.
Vlocity Health Insurance Solutions
Healthcare Digital Front Door
Whether through acquisition or expansion of capabilities, we are seeing the merging of providers with payer activities that requires a digital focus. See how you can manage these new responsibilities, streamline operations, and improve member access to a variety of services with Salesforce.
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Managed Services
Many Salesforce customers and consultants focus all of their energy on the initial configuration of the platform but haven’t considered their long-term strategies for continued success. Most of the hard work begins after go-live and as things change, the work never ends.
At Silverline, we have years of experience helping our clients thrive after implementation. Learn more about how we can help drive ongoing success for your Salesforce Org.
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Unify Your Member Services Team with Salesforce
Payers fight a never-ending battle to effectively manage relationships with the provider, group, and member communities. And that work comes in addition to traditional operational challenges like claims processing times and aging technology.
How do you keep up?
This on-demand event demonstrates how to empower your organization with Salesforce. Where do you start? How do you do start?
On-demand recording
Our Industry Partnerships
Amida Care
Amida Care is a private, nonprofit community health plan that specializes in providing comprehensive health coverage and coordinated care to Medicaid members with chronic conditions, including HIV/AIDS and behavioral health disorders. They serve 7,000+ members throughout the five boroughs of New York City, including people living with HIV/AIDS; people who are experiencing homelessness, regardless of HIV status; and people of transgender experience, regardless of HIV status.
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Our Clients
