We created the SOLUCIONA strategy to optimize results for various key players in the healthcare industry.

How does SOLUCIONA work?

Based on our DETECTA philosophy, SOLUCIONA takes into account the different healthcare models in Colombia along with their underlying problems to achieve financial stability and overall service quality. RGC improved its operating model by applying industry best practices, stabilization measures, process improvement techniques, thorough analysis and our overall expertise.

How do we do it?

Our method

Expenditure analysis

We know that business leaders rely on a great deal of information that must consider strict compliance, regulatory measures, rules and business policies in conjunction with the insurance company at the beginning of every operation. We always consider these various conditions a risk and; therefore, work to refine them according to their critical level.

You can detect unnecessary expenditures when you:

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Ensure that the collection is appropriated and details exact information on the expenditure behavior for your business model.

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Validate that the audit criteria is applied according to your guidelines.

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Act timely according to the analysis of reserves, claims, among other factors.

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Have the information provided by our ACTIVA platform to control fraud or possible undue charges.

Medical cost management

Medical cost management is essential to properly diagnose the economic health status of your company. We support your operation with organized, clear, accurate and timely data. This way you can identify relevant costs, make assertive decisions and better allocate your resources that optimize operations, while creating timely business opportunities to grow.

You can properly diagnose inefficiencies when you:

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Establish and implement automated controls that help you minimize operational risks.

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Notice trends and deviations to minimize risks and cost overruns.

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As a result of integrated information systems, validate data quality, detects inconsistencies, and take immediate action.

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Identify trends, deviations, cost overruns and even improper practices to analyze the expenditure behavior.

Strategic management

Using our strategy as KPO, ACTIVA plays a fundamental role (along with the insurer) because we can design the data structure required to verify the concurrence of processes in order to transform them into information that helps them refine their guidelines and establish corrective actions that improve the supply service model.

You can proactively manage risk when you:

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Use ACTIVA to understand the information in order to guide and intervene your business.

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Identify and control risks through automated processes.

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As a result of integrated information systems, validate data quality, detects inconsistencies, and take immediate action.

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Develop an action plan to correct deficiencies from the event day and service start date until its completion.

Risk management

Using our strategy as KPO, ACTIVA plays a fundamental role (along with the insurer) because we can design the data structure required to verify the concurrence of processes in order to transform them into information that helps them refine their guidelines and establish corrective actions that improve the supply service model.

You manage risk when you:

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Convert data into business intelligence through ACTIVA to make strategic decisions.

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Better manage resources in a timely manner and improve the financial health of your company.

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Identify and avoid cost overruns in the process.

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