Investigations Module®

 Investigations Module®The Simple Way to Manage Compliance Issues

No one wants to dwell on managing CTMs, reports of impropriety or questions about benefits; but it’s an unfortunate part of the business. Mishandling these investigations can have serious – and costly – consequences to health plans.

We have the solution to help compliance directors manage this process.

Developed specifically for health plan compliance departments, the Investigations Module® is the first-of-its-kind full-cycle tool that allows health plans to best manage investigation issues, from reporting to resolution.

With the Investigations Module®, You:

  • Streamline and simplify workflow with an industry specific investigations tool that captures comprehensive complaint information to fully investigate, remediate, and report case outcomes
  • Get specialized workflow management tracks for complaints related to Sales and Marketing, Fraud/Waste/Abuse, HIPAA/IT Security, Legal, and HR issues
  • Capture information to support annual CMS reporting requirements regarding agent oversight for both Part C and Part D plans
  • Have a document management library to centralize investigation documents and reports
  • Have links to user-defined documents such as regulatory guidelines, internal policies and procedures, HR handbooks, and Code of Conduct guidelines
  • Gain centralized communications with the Investigations Discussions feature
  • Can easily generate investigation reports, as well as user and management reports