Governance, Risk, and Regulatory Compliance
Prevent fraud, ensure compliance, and reduce risk.
Protect your patients and members by ensuring your organization meets industry compliance standards on the Appian HIPAA-compliant and HITRUST-certified cloud.
Better track, manage, and report on compliance requirements.
Bexley Health implemented a solution with Appian in less than a week to ensure compliance within the NHS across Primary Care and the wider local health & social care system.
- Complaints, Appeals, and Grievances
- Contractual A/R and A/P Management
- Fraud, Waste, and Abuse Investigation
- Physician Services and Reimbursement Tracking
- Automate your member appeals
Expedite processes and provide a clear explanation of benefits to your members. - Simple exception handling
Easily handle and automate both commonplace appeals and exceptions to provide faster customer service. - A single source for claims visibility
Run a seamless complaints, appeals, and grievances process to provide members the service they expect.
- A single system for contract management
Reduce errors and risk with a single staff login for organization wide contracting.
- Referral management that makes compliance simple
Ensure alignment with anti-kickback and anti-bribery laws to stay within contractual parameters.
- Save time and money while improving accuracy
Achieve a real-time, unified view of physicians and cash flow while consolidating data silos.
- Stop needless financial loss before it starts
A solution to detect fraud before it happens and support case investigations. - Streamline internal and external collaboration on fraud
Easy coordination between internal departments and law enforcement for faster fraud detection and resolution. - A unified view of all in-progress FWA Cases
We provide solutions with the urgency you need for faster financial recoveries and resolutions
- Ensure effective clinical quality reviews from start to finish
Track clinical quality measures and ensure they’re being properly carried out. - Reduce readmission rates and increase patient satisfaction
Help providers spend less time on admin duties and more time on patient care. - Unify multiple systems to create a single source of truth
We make it possible for all services to be tracked in one place for easier management and better patient care.
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