Product & Plan Configuration Services
Faster resolutions. Improved member and provider experiences.
Sagility helps health plans operationalize complex product, plan, and benefit designs with confidence, ensuring plan intent is accurately reflected in day-to-day claims operations.
Overview
As part of Sagility’s Claims & Membership Management suite, our Product & Plan Configuration Services help health plans accurately configure benefit plans, products, pricing, and rules across core claims platforms. By aligning plan design, benefits, pricing, cost-share logic, and accumulators at the source , we reduce downstream claims errors, rework, member abrasion, and provider friction.
Product & Plan Configuration
- Configure products, plans, and benefits across claims platforms
- Translate plan design, contracts, and regulatory requirements into system-ready rules
- Set up pricing, cost share, accumulators, limits, and benefits logic
- Support new product launches, renewals, and mid-year benefit changes
- Validate configurations through testing, QA, and audit-ready documentation
- Maintain alignment across enrollment, billing, and claims systems to prevent defects
Decades of Partnership, Performance, and Progress.
Clients stay with Sagility for a reason: deep-domain expertise, measurable outcomes, and a true partnership approach. Purpose-built for healthcare and trusted by the nation’s top health plans and providers, we bring decades of experience and a proven ability to simplify operations and deliver lasting impact.
Straight from the Source
We’re more than a vendor, we’re a partner. Here’s what our clients have to say:
I love working with the Sagility team. They are professional, caring, and always willing to help wherever needed. They deliver high-quality work promptly and consistently exceed expectations.
Senior Payment Integrity Professional,
National Health Plan
They have done an outstanding job serving as our primary point of contact and consistently delivering beyond expectations. They champion our requests and help hold the right stakeholders accountable — including themselves. Sagility is a partner we can rely on for timely execution and transparency. The team is highly capable and consistently meets our requirements.
Director, Partner Operations,
Leading Provider Organization
Sagility consistently meets quality targets and maintains excellent service standards. The team is extremely flexible and ready to assist whenever needed.
Supervisor,
Regional Health Plan
Case Studies
See how we’ve helped payers unlock millions in savings and streamline operations:
Insights & Resources
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