Formativ Group

Healthcare Consulting Services for Salesforce, Data & AI Success

Innovation that improves care delivery. Harness the power of modern healthcare technology to streamline operations, enhance patient experiences, and strengthen coordination across providers. Do more in less time with Salesforce Health Cloud and intelligent healthcare solutions designed for a connected, data-driven ecosystem.

The Challenges Holding Healthcare Organizations Back

Claims Inefficiency:

“Your claims process is hemorrhaging millions in manual errors and delays”

Health insurers lose millions to slow, manual claims processes that are prone to errors and rework. Outdated workflows increase costs, delay payments, and frustrate both providers and members. With regulatory rules constantly changing, compliance risks also rise.

Provider Network Gaps:

“20% of your provider directory is wrong and regulators are watching”

Inaccurate provider directories and slow credentialing frustrate members, erode provider trust, and risk fines. Manual processes often take weeks, causing onboarding delays and service gaps. This also creates compliance challenges with CMS and state regulations.

Regulatory Compliance & Reporting:

“Compliance errors could cost you millions in fines and reputational damage”

Constant CMS, HIPAA, and state-level changes force insurers into costly manual reporting and audits. Errors or delays risk fines, reputational damage, and member complaints.

Care Coordination Challenges:

“Poor care coordination is costing you millions in preventable readmissions”

Insurers often fail to coordinate effectively with providers, case managers, and members. Lack of shared data leads to gaps in chronic care management and missed opportunities for preventive interventions.

Fraud, Waste & Abuse (FWA) :

“You're paying fraudulent claims because detection comes too late”

Billions are lost each year to fraudulent claims, duplicate billing, or abuse of services. Manual detection is slow, reactive, and expensive.

Network Adequacy & Credentialing:

“Weeks-long credentialing is leaving gaps in your provider network”

Carriers need to onboard providers quickly to maintain network adequacy, but credentialing often takes weeks. Providers lose revenue while waiting, and carriers risk inadequate coverage in key markets.

Typical Client Results

50%

Reduction in Patient Intake Time

45%

Increase in Appointment Scheduling Efficiency

40%

Reduction in Contact Center Call Volume

55%

Reduction in Manual Care Coordination Tasks

35%

Increase in Patient Engagement

30%

Reduction in No-Show Rates

60%

Improvement in Referral Processing Speed

40%

Reduction in Administrative Burden

Benefits of Working with Us

When claims stall, networks break, and audits loom, everything feels reactive. Salesforce gives healthcare teams back control with connected data, automated workflows, and real-time visibility.

Faster Claims Processing

Automated intake, routing, and validation replace slow, manual claims workflows, reducing rework, accelerating payment cycles, and lowering operational cost.

360° View of Providers

Provider data lives in one centralized system, keeping directories accurate, credentialing status current, and network coverage compliant across all markets.

Continuous Compliance

CMS, HIPAA, and state-level requirements are enforced within the system through automated reporting, audit trails, and real-time documentation.

Connected Care Coordination

Shared data across payers, providers, case managers, and member services closes care gaps, supports proactive outreach, and reduces preventable readmissions.

Fraud Prevention

Suspicious claims activity is detected earlier in the lifecycle using automation and analytics, preventing improper payments before losses multiply.

Unified Operations

Claims, compliance, provider data, and care workflows operate from a single, secure system, supporting large operations without fragmentation.

Core System Integration Expertise

Epic & Salesforce Integration Services

Oracle Cerner & Salesforce Integration Services

Waystar & Salesforce Integration Services

Meditech & Salesforce Integration Services

Nextgen Healthcare & Salesforce Integration Services

Customer Stories

Revamped Their Customer Support Solution

Get Started

Bring clarity and coordination to your healthcare organization.