Skip to main content

Measured outcomes

What this programme actually delivered.

38%

Inquiry-resolution time: down 38%

+1

CMS Star Rating: +1 point

+22

Member NPS: +22 points

2.4

2.4M members on unified service platform

The challenge

A regional health plan’s 2.4M members had inquiries handled across 6 separate systems. Inquiry-resolution times were lagging peers; CMS Star Rating was at risk.

What we built

Unified CSM with HIPAA-compliant routing. Cross-domain context (member benefits, claims, provider, pharmacy). Real-time CMS-metric dashboards.

Outcomes

Planning Your Next Initiative?

Whether you're modernizing an existing platform, implementing new capabilities, or exploring AI-driven transformation, Mergen's certified experts will help define the right roadmap, scope, and delivery approach for your business.

Book a Discovery Call