Laguna Insight · From Laguna Health, an Elligint Health company
Care Management Quality Assurance on Every Call, Not a Sample
Laguna Insight scores every member call against your plan’s own quality standards, then turns the results into coaching, dashboards and data for accreditation reviews.
NCQA · URAC · HEDISdata from every call for accreditation and quality reviews
TIMEBest Inventions 2024, AI category
About Insight
What Is Laguna Insight?
Laguna Insight is care management quality assurance software for health plan care teams. It scores every member call against your plan’s own quality standards, instead of the small sample a quality team can review by hand.
Insight turns the results into coaching for care managers, dashboards for leaders and data for NCQA, URAC and HEDIS reviews.
Insight is part of Laguna Health, an Elligint Health company, and works inside the systems your team already uses. People make every clinical decision.
Connects to
TelephonyYour member calls
Member dataSent by your plan
IdentitySingle sign-on
On every call
ScoreAgainst your own forms
CoachFeedback for care managers
ReportDashboards and review data
Insight stands on Laguna Reef. Laguna Current keeps every output correct.
The problem with sampling
From a Small Sample to Every Call
Most quality teams can review only a handful of calls a month by hand, so coaching and audit answers depend on which calls were pulled. Insight reviews every call against the same criteria.
Manual QA sampling
A handful of calls a month
Reviewed by hand, so most calls are never heard, and scores can vary with the reviewer.
Laguna Insight
Every call, scored the same way
Every call is scored against your plan’s own forms, with the same criteria for every care manager.
Score, Coach and Report on Every Call
Insight turns quality review from a monthly sample into a system your whole team can use.
1
Score
Every call
Insight scores each call against your plan’s own quality forms, whether a care manager or LISA led the conversation.
2
Coach
Every care manager
Supervisors coach from the exact moments on the exact calls that matter, not a generic score.
3
Report
Every review
Dashboards and exportable data give leaders a full view of quality and support NCQA, URAC and HEDIS reviews.
Built for the Teams That Own Quality
Quality and Accreditation Teams
Review every call instead of a small manual sample, with exportable data for NCQA, URAC and HEDIS reviews.
Supervisors and Trainers
See and coach on every call, scored against your own standards, instead of the few calls you can get to by hand.
Care Managers
Get specific, consistent feedback on every call, held to the same criteria as everyone on the team.
Care Management Leaders
Hold quality steady as caseloads grow, and report quality to leadership from every call, not a sample.
Laguna Current
Quality Scores Your Team Can Trust
Insight scores calls against your plan’s own forms, not a generic contact center scorecard. Laguna Current, the correctness system under every Laguna product, keeps every evaluation true to your standards.
Fit to your plan’s own quality forms and audits
Each version tested before go-live
Watched by an AI judge during business hours, with clinical experts reviewing the flags
The same standards for calls led by care managers and by LISA
Laguna Current
Even Better With Laguna Companion and LISA
Each product stands on its own. Used together, they share what they learn, so every conversation improves the next one.
Laguna Companion
An AI co-pilot for every care conversation
Companion gives care managers a quick member view before the call, surfaces member needs during it and drafts the documentation after it.
Helios Runs the Work. Laguna Makes Every Conversation Count.
Helios CM and Helios UM run your care and utilization management workflows. Insight reviews the member conversations inside them against your own quality standards.
Helios® by Elligint Health
Runs the work
Care plans, tasks and workflows
Authorizations, reviews and appeals
Analytics across populations and programs
Laguna Insight
Makes every conversation count
Quality review on every call
Coaching from real conversations
Data for accreditation reviews
Integration with Helios is planned in phases, starting with Laguna Companion. You don’t need Helios to use Insight, and Helios clients can add it at any time.
Laguna Insight is care management quality assurance software from Laguna Health, an Elligint Health company. It scores every member call against your plan’s own quality standards and turns the results into coaching, dashboards and data for accreditation reviews.
Does Insight use our own quality forms?
Yes. Insight scores calls against your plan’s own forms and scoring system, not a generic contact center scorecard. Laguna Current fits each form to your standards and tests it before go-live.
Can Insight help with NCQA, URAC and HEDIS reviews?
Insight scores every call against your plan’s own forms and turns the results into exportable data for NCQA, URAC and HEDIS reviews. Accreditation decisions stay with the accrediting bodies.
Does Insight replace supervisors?
No. Insight gives supervisors complete, consistent evidence from every call, and supervisors lead every coaching conversation. People make every clinical decision.
Does Insight review calls handled by LISA?
Yes. Insight scores calls led by care managers and calls led by LISA, Laguna’s AI agents for routine outreach, against the same standards.
How long does it take to go live?
A typical go-live takes about six weeks from kickoff, and it can take as little as three. Your team tells Laguna’s AI agent how you document. It drafts your documents and tests them with you before go-live, and a Laguna team works beside you.
Can we start with Insight on its own?
Yes. Each Laguna product delivers value on its own, and Insight works inside the systems your team already uses. Used together, the products share what they learn across the care conversation.
Does Insight work with Helios?
Integration with Helios is planned in phases, starting with Laguna Companion, and Insight works without Helios today. It runs alongside the care management platform you already use, and Helios clients can add it at any time.
Ask an expert
Ask an Expert About Laguna Insight
See how Insight would score calls against your plan’s own quality forms. An Elligint Health expert will follow up within one business day.
Already a Helios® client?Your account team can walk you through Laguna for your plan.
It’s so encouraging – I love that! It’s like, ‘You’re doing a really great job,’ and I love that. It’ll keep me going. That’ll help stave off the burnout!
Care ManagerRegional Health Plan
It’s just phenomenal that we have 99% accuracy. As a nurse, you have to trust the results, because it’s your name, your license.
Director of Case ManagementMulti-State Health Plan
I can’t believe we get so much 1:1 time with you still. Most vendors just sign and then are gone.
I’m not having to take notes. I’m not missing information. It takes a weight off my shoulders where I can actually sit and have meaningful conversations… it’s life-changing.
Intake / Care Coordination StaffCare Coordination Organization
Laguna has significantly improved my productivity. The time savings allow me to make an extra call each day without letting documentation pile up.
