Success Story -

About CGS Administrators LLC

CGS Administrators is a Medicare Administrative Contractor for the Center for Medicare and Medicaid Services. They serve a broad audience that includes Medicare providers, and medical equipment suppliers. With over 50 years of experience, they pride themselves on lowering operational costs, streamlining revenue and time-consuming processes all with a world-class approach to customer service. CGS impacts the lives of over 28 million Medicare beneficiaries and over 105,000 healthcare providers and suppliers. While they are headquartered in Nashville, Tennessee they process claims for beneficiaries in 38 states. CGS is a member of the BlueCross BlueShield of South Carolina Celerian Group which is a family of companies focused on the administration of government healthcare plan benefits.

Industry

Healthcare

Software

ChangeGear Change Manager, Advanced Change Pack

Benefits

• Efficiency
• Automated previously manual responsibilities
• Enhanced accuracy and reporting

The Challenge

CGS Administrators were using a custom-tailored system and multiple software tools as a solution for managing change requests and reporting requirements for their customer. The original software developer left the company, and the patchwork solution became an obstacle in an otherwise efficient and customer focused organization. The change management team could not update or change the software. The custom software resulted in more manual work to achieve the same results. The entire solution (including standalone tools) was not integrated or working effectively.

The reporting process was lengthy, with monthly and quarterly customer reports taking far too long to compile. When change requests came in, the analysts had to enter them in the system and manually push out to the end-users. End-users couldn't access the system to review any change themselves. They had no visibility and were dependent on the compliance team for information.

The Solution

"The relationship with the Professional Services team is great. The upgrade went smoothly. It is very rare that we need to seek additional support and open a ticket. In all these years, we continue to be very pleased with the relationship and ChangeGear." — Vice President, Compliance Officer at CGS Administrators

The search began for a comprehensive solution that would improve the process, reduce manual data entry and workload, improve reporting and access to the information. A detailed analysis and request for proposals were issued. ChangeGear was selected as the vendor of choice. The buying team included compliance change management staff, Operations Subject Matter Experts, senior leadership and IT. The Vice President of Compliance, spearheaded the research and selection. They served a dual role reporting to the President of CGS Administrators and to the Compliance Officer at Celerian Group. CGS was seeking an on-premise solution that would reside on their server and technology grid. Managing government contracts requires strict adherence to data privacy. Change requests need to be carefully managed to meet regulatory and compliance standards.

Other vendors were more expensive but did not deliver the robust change management functionality that was required, and were limited in their offering.

ChangeGear offers customers flexible solutions which included an on-premise solution which was a requirement.

Customization was also important to CGS Administrators with their unique operations. They required capacity for multiple users. With a license that offered flexibility around both named and concurrent users, ChangeGear met their needs. Volume was also a consideration with hundreds of change requests a month requiring tracking implementation and reporting. With multiple contracts to oversee, each included 10-15 workloads per contract and the ability to track each change at the requirement level. Each group would be impacted by the solution and have unique needs. CMS or known as the Center for Medicare Services, mandates security requirements which IT oversees. This includes the integration of ChangeGear across the IT infrastructure (applications, server, hardware, network, etc). They also met with the Compliance Committee for the CGS Administrators board of directors. There is no doubt that selecting the most effective change management solution was a priority and the pressure to identify the best solution would be very visible across not just the internal team and partners but with senior leadership.

ChangeGear Change Manager was implemented initially in 2019 with six named and 25 concurrent user licenses. The team also chose the Advanced Change Pack with includes additional features around more complex change calendar capabilities, approval hierarchy, etc. A complex approval process was something they required to manage multiple levels and authorizations. In 2022, the team worked with Serviceaide to upgrade to ChangeGear version 8.

The Results

"Now, we are not only more efficient, but we are precise. Our end-users have real-time access to information and have the necessary tools to manage assignments." — Vice President, Compliance Officer at CGS Administrators

Post implementation, the difference in process and results was night and day with ChangeGear. On a day-to-day basis, the change management process was more automated and efficient. Performance improvement was also notable. The team consistently meets their service level agreement of on time delivery 100% a quarter.

Access to information was a significant benefit. Previously the Compliance team acted as a service organization updating change requests as they came in by providing access to the end users, it significantly reduced the workload and communications burden previously on the Compliance team. The workload is quite heavy. Everything is tracked at a requirement level. A change request can have hundreds of requirements. Many are complex requests requiring unique customization. Now 80 plus end-users can access and act on the information they need versus waiting for it to be sent. By eliminating the role of a service organization in Compliance, it freed the analysts up to focus on other requirements. This is a powerful example of how self-service capabilities can transform an organization.

Not only is CGS Administrators satisfied with their internal process, but their customers report high levels of satisfaction. In fact, representatives of their primary customer who viewed the system have reported that the CGS Administrators process is the "best they have ever seen". The team was asked to share how they transformed change management and compliance with other Celerian Group Companies. The CGS team is pleased to share their best practices and how ChangeGear became an important foundational part of their solution.

About Serviceaide

Serviceaide is a leader in modern service management. Serviceaide's vision is to transform service management, across ITSM, ESM, and Customer Service. Serving customers around the world, Serviceaide applies breakthroughs in artificial intelligence, machine learning, and natural language processing to deliver better experiences, provide enhanced self-service and empower service owners. Serviceaide transforms service through digital labor conversations, automation, and knowledge.