Bookshelf v7.5: Siebel eHealthcare Functionality

Siebel eHealthcare Functionality

Siebel eHealthcare offers a solution for relationship management in the healthcare market that includes the health insurance, employee benefits, and care delivery sectors. Built on the strengths of Siebel's industry-leading eBusiness applications, Siebel eHealthcare allows organizations to successfully manage relationships throughout the entire customer lifecycle, across all stakeholder touchpoints. This provides a platform for identifying new opportunities and expanding upon existing business relationships. Recognizing that success comes from relationships with the expanded community of stakeholders, Siebel eHealthcare's suite of applications focus on the expanded healthcare ecosystem: insurance subscribers and members as well as employer accounts, independent brokers, direct sales channels and providers (health systems, physicians, hospitals, networks, ancillary providers).

By using Siebel's eBusiness applications, Siebel eHealthcare provides solutions to address the industry's most pressing business issues.

The Siebel eHealthcare solution sets include:

End-to-End Sales

Manage Opportunity and Account Tracking for prospecting, renewal, and lost business analysis

Team based selling (including external team members such as brokers)

Sales Manager views to facilitate team management

Embedded Sales strategy tools such as Miller-Heiman Strategic Selling

Capture of information for rating and underwriting such as census and health risk assessment

Automation capabilities to make sure that quotes and installed cases move through the organization

Agent/Broker/Consultant Solutions

Profiling capabilities to track licenses, appointments, errors & omissions coverage, agency affiliation

Ability to assign an agent or broker to an opportunity or account

Management tools to assess the relative value of various selling partners

Delegated administration to allow agencies to administer their own user names and passwords

Group Account Relationship Management

Ability to communicate new product information and tailored messages about the plan consistently across every interface

Streamline the open and ad hoc enrollment processes. Employees can self-enroll online or administrators can submit enrollment by using the group portal

Manage service issues with analytics and reports. Employers can have visibility into aggregate claims data, physician networks and other relevant plan information

Promote online self-service as an avenue for quick resolution of billing issues

Agent Tools

Support demand from web, fax, phone and email from a single interface

Address common inquiries with a dashboard of eligibility information, claims history, service history, and log of customer interactions

Use assignment manager and workflow products to allow agents to follow best-practice procedures

Allow new agents to get up to speed through the use of scripting tools and a common solution library

Health Management

Use the Events module to track available health classes and clinics and enroll members and patients

Create Activity plans and use workflow tools to outline the appropriate activities and resources required to proactively manage care

Develop campaigns for managing enrollment of at-risk populations in care management programs

Provide information to educate members on critical life events, disease specific services, and available health classes

Use analytics capabilities to track and monitor the success of classes and programs

Provider Relationship Management

Consolidate critical information from back office systems related to individual physicians and other providers. This supports effective responses to inquiries and proactive management of the contracting relationship

Track key information on individual physicians such as panel size and status, location, office hours and hospital admitting privileges

Search for providers and facilities in a geographic radius using Geocode searching capabilities

Access provider information online using a secure website

Generate provider reports by specialty, product, or state

Offer provider portal to promote self-service for common inquiries