Member Experience / A&G Universe Generator

Drive regulatory compliance with smart A&G universe management

Automate the aggregation, scrubbing, and validation of your A&G data, reducing manual effort and minimizing errors.

Value & Benefits

Optimize your member support operations

The A&G Universe Generator is designed to bring unparalleled efficiency and accuracy to your Appeals & Grievances processes. Explore how the tool delivers value that transforms your compliance efforts into operational success.

Value
Benefits

Transform your A&G processes into seamless, compliant, and efficient systems by automating universe generation and generating real-time insights from your A&G data.

Drive efficiency, accuracy, and better outcomes by automating critical A&G data processes and getting real-time insights.

Automated universe generation

Simplify the creation of A&G universes with automated scrubbing saving time and reducing the risk of manual errors.

Enhanced compliance

Meet CMS standards with built-in compliance checks, minimizing the risk of non-compliance and improving audit readiness

Operational efficiency

Streamline your A&G processes with a centralized platform that reduces manual effort allowing your team to focus on higher-value tasks.

Real-time insights

Gain immediate access to up-to-date data and actionable insights, enabling you to proactively identify and address discrepancies.

Key features

Provide CMS-compliant A&G universes instantly

Automate the formatting of appeal and grievance universes with a single click, saving time and reducing manual errors.

A&G management

Effortlessly manage appeals and grievances! Automate workflows, reduce manual effort, and ensure timely resolutions. Improve compliance and operational efficiency while enhancing member satisfaction with seamless, accurate, and real-time tracking of appeals and grievances. ×

Member journey dashboard

Gain Comprehensive Insights into Member Journeys! Track every touchpoint and interaction across the member lifecycle, providing a holistic view that drives better decision-making. Identify trends, improve service delivery, and increase member satisfaction with detailed, actionable insights. ×

PQI & QIO

Ensure the highest standards of quality care with our Potential Quality Issue (PQI) & Quality Information Organization (QIO) solutions. Automate quality improvement processes, monitor performance metrics, and comply with regulatory standards. Drive continuous improvement in care delivery and outcomes, and maintain excellence in healthcare services. ×

Data scrubber suite

Our Data Scrubber Suite helps you maintain clean, accurate data for all your reporting needs. Automate data scrubbing processes to identify and correct errors, ensuring compliance with regulatory requirements. Improve data integrity, reduce risks, and enhance decision-making with reliable data. ×

Intelligent scrubbing

Ensure data accuracy with rule-based scrubbing

Automatically enhance the quality of your A&G data with intelligent, rule-based scrubbing using predefined rules to identify and correct data discrepancies, ensuring that your universe is accurate, consistent, and compliant with CMS standards.

Compliance monitoring

Identify and address issues before the audit

Stay ahead of potential compliance issues with proactive monitoring and validation. Identify discrepancies and data quality concerns early in the process, allowing you to address them before they become audit risks.

Data volumes

Handle large data volume through batch processing

Scrub, validate, and aggregate high volumes of data by automating batch processing, ensuring accuracy and compliance without slowing down operations, and ensuring timely data preparation for audits and reporting.

Reporting

Generate regulatory reports in just one click

Simplified reporting tools allow you to quickly generate detailed, accurate reports for internal review of compliance status or audit purposes, enhancing your ability to communicate effectively with stakeholders and regulatory bodies.

Usher AI