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Payer

Improved member engagement with a 360-degree view.

At Silverline, we create long-term relationships with our clients by working with them on their strategic objectives, providing thought leadership, and ensuring the highest quality of services that suit their unique needs.
Paul Peterson Client Partner

Member engagement remains a top concern for Payers

This is particularly due to the wide variety of interactions Payers have with their members. Today’s Payers contend with challenges such as poor visibility into key information needed to serve their members, disparate or siloed systems that can limit the effectiveness of the interaction with a member, lack of automation that can create inefficient engagement processes, and disconnected or missed member touchpoints. Above all else, Payers need the processes and information that allow them to create a positive experience with their members during every interaction.

The foundation for member engagement begins with a member relations workflow-centric service center and a 360-degree view of every interaction with a member. Maximizing the member experience requires a consolidation of the information needed to best serve them in an easy-to-use presentation. Navigating this consolidated view must be easy and intuitive, and must be personalized for each member. Ultimately, the processes used by the member relations teams should lead the member through a journey that creates a positive experience for both parties.

Provider Relationship Management

Creating and defining your provider network is a critical first step in patient engagement and navigation within your healthcare system. How can we help you achieve this?

  • Create robust provider and clinic/facility profiles
  • Manage provider scheduling rules and patient acceptance criteria
  • Create a referral network and manage geographic and service line gaps
  • Provider acquisition, onboarding, and credentialing with integration to legacy credentialing systems
  • Quality program tracking and management
  • Physician liaison workflow and management
  • ACO/CIN network design and management

The results are continuity of care for your patients — increasing patient loyalty and enabling the tracking of network integrity and quality — and increased opportunities to drive and retain downstream revenue within your network.

Health Cloud

Members rarely navigate their health journey alone. Collaboration and transcending transactional systems are key to a rewarding experience for all Payer stakeholders. In that same spirit, we recognize that integration with key processing systems and a robust workflow drive connection and efficiency.

Creating a user experience on Health Cloud that reframes and presents internal and external data about a member or provider can enhance the member experience while increasing the efficiency and effectiveness of each engagement. We make personalized engagement possible on Health Cloud through workflow-driven queue and task management; omni-channel support; myriad streamlined service actions. Health Cloud also makes it easy to integrate with Payer systems such as administration, claims, billing, and state and local government systems.

Marketing Cloud

Members today expect a more connected, personalized experience. You can help members and member relations team members alike by articulating when the next touchpoint of engagement will occur (i.e., the next step in enrollment or the next step in their care plan). The right marketing automation can proactively provide status updates using individualized communication preferences, increasing member satisfaction and decreasing call volume to the member relations team.

With Marketing Cloud, we enable Payers to provide the experience that best serves members and member relations team members through:

  • More relevant and timely communications 
  • Alignment of member acquisition activities
  • Creation of member journeys to support care management plans
  • Coordination of communications and interactions between members, caregivers, and other stakeholders in the health of members

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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Digital transformation powered by Vlocity and Silverline

We provide technical expertise and end-to-end support to kickstart your Salesforce implementation and help you succeed after go-live with ongoing support, managed services, and more. Our partner Vlocity delivers industry-specific cloud and mobile software that embed digital, omni-channel processes for Payers. Vlocity has best-of-breed code-free insurance and health software — built and run on Salesforce — that makes digital transformation possible in quarters rather than years.

Together, we provide the digital transformation strategy, implementation expertise, and pre-built software solution businesses in the health and insurance industries need to compete.

The winning combination of people, process, and technology

As a consulting company with real experience in the Payer industry and expertise in Salesforce — a software platform that combines engagement layer capabilities like marketing automation, sales automation, and omni-channel service, with core payer Insurance capabilities like Enrollment, Benefits Management, Underwriting, Care Management, Utilization Management, Quality Management and Billing.

Combining best-in-class capabilities in one platform largely eliminates integration costs and maximizes speed to market. Silverline’s payer expertise, Salesforce’s Clouds, coupled with Vlocity’s core payer solutions is the team that provides this ideal partner mix for transformation.   — we can help you get there.

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