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.

 
  • 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.

Because we care about the safety of your data and processes, we build Appian from the ground up for enterprise-grade security, scalability, and reliability so you can focus on running your business and what makes you unique.

- Omesh Agam, Chief Information Officer, Appian

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Learn how Appian can help health plans expedite complaints or appeals for increased member satisfaction.