​Virtual Appeals Manager (VAM)
A Single Source of Truth for Effective, Efficient and Compliant

Appeals & Grievances Operations

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Virtual Appeals Manager provides real-time

dashboard monitoring of key metrics and alerts. It also:
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Appeals & Grievances

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• Supports monitoring, management, reporting, and granularly tracking of unique appeals, grievances and CTM case files
• Designed for regulated health plans
  
• Supports Medicare, Medicaid and other regulated lines of business
  
• Highly configurable
  
• Eliminates manual processes
  
• Enables plans to more effectively maintain compliant A&G operations
  
• Supports highly complex yet simple to manage business rules
  
• Intuitive user interface
  
• Enables users to create and maintain rule sets
  
• Flexible workflow rules engine with multiple configuration options ensure that essentially any business rule can be supported with native functionality:
  

• Trigger Points
• Outcomes
• Due Date Logic
• Case Flags
• and more!