Why choose RGC?
As experts in the healthcare services sector, we have the ability to adapt to each service model and to every requirement proposed by each insurance company. This flexible and deep insight, along with ACTIVA, enables us to apply results-driven tactics that meet each client’s business needs.
More than 10 million audited accounts for more than 10 billion pesos* (ACTIVA data).
More than 90 scopes in BPO services, adjusted to each operational model of health services.
RGC has grown 60% in services billing through recent years.
We developed more than 30 web services, intergrating ACTIVA with more than 10 different platforms.
AMAZON is our ally on data storage, providing agility, security and reliability on a global scale.
AVAILABILITY and COVERAGE
According to the client’s requirement, we offer human talent whenever and wherever you need it.
We have a portfolio of more than 16 clients in various healthcare service models.
More than 80 health professionals in auditing processes and a more than 300 employees throughout the country.
Our experience by sector
Our work specializes in each area of the healthcare services sector, providing solutions that are effective and will make you our next success story.
We want to showcase inspirational stories that show how RGC has helped different healthcare service providers create a competitive advantage via processes improvement and risk detection and management.
Project-oriented to claims handling, related to compulsory car insurance (Soat by its Spanish acronym) claims, applying the best practices for the total process management. From the audit results, we have improved processes associated with document management, audit specialization, continuously overcoming the criteria and the medical, legal and administrative conceptualization of the process.
Integral structured model in the ACTIVA platform, which allows to analyze information and manage your business.
WEB SERVICES INTEGRATIONS
Data Validation and payments notification in real time, as a result of automation.
Continuous optimization of processes to obtain better performance.
We implemented standards and best practices for document management of medical bills presented by occupational risk management suppliers (ARL by its Spanish acronym), Prepaid Medicine and Hospitalization and Surgery Policies. For this, we made a technological integration with ACTIVA through web services for data validation and payment notification.
Structuring of the activities pro models optimization.
Platform modeling according to the client’s requirements.
DATA SHARED MODEL
Processes and medical bills automation with ACTIVA.
We carried out the on-site medical audit, and medical bills audit, bills from the hospital and outpatient care of the workers affiliated with the company, reporting the results on their technological platform. This includes reimbursements and disabilities audit. Accompanying the result, the management team implemented a comprehensive quality audit of health services providers validating criteria of accessibility, opportunity, and efficiency.
PRESIDENTIAL MEDICAL AUDIT
Focused on managing growth opportunities, efficiency and patient care.
Data verification and validation to improve the service model.
We implement improvements and new services according to the evolution of the project.
Our experts say
According to new trends in technology and evolution of the operating model, we rely on the opinion of experts in the health sector to deliver better results, applying new rules and policies that capture the specific needs of each insurance provider.
JAIME RAMÍREZ PhD
Doctor in Health Economics
Expert in Colombia’s Health System
Because of his training and deep understanding of the economic makeup of the healthcare industry, Dr. Ramirez is considered a knowledgeable resource in RGC due to his experience manages financial resources related to disease treatments, proactive health, and wellness. Also, he helps organizations to implement strategies that improve efficiencies and the overall quality of their services.
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