Healthcare Payer
As thought leaders who modernize health plans to improve overall care services, you’ll need the right tools to seamlessly coordinate service across the care continuum. We can help you to fast-track digital optimizations fostering collaboration, innovation, and convenience, to drive personalized services and improved outcomes.
What we deliver
Product Development
Plan development
We collaborate with you on solving real-world challenges using agile approach and emerging technologies.
Channel management
We address changing market dynamics and patient needs by identifying opportunities to adjust your channel strategies.
DevOps solution
We create a framework for seamless assessment, migration, and implementation, accelerating CI/CD pipeline management for rapid delivery and continuous improvement.
Product testing services
We work with you to develop comprehensive testing solutions, including smoke, performance, regression, and security automation, ensuring robust and reliable systems.
Member Engagement
Enrollment and eligibility
We ensure a seamless user experience by developing user-friendly platforms and applications that streamline enrollment processes and eligibility verification.
Endorsement and renewal
We optimize the renewal process and enhance user engagements with automated endorsement and renewal systems offering personalized notifications and reminders.
Risk identification, provider contract, and assessment
We improve healthcare outcomes by using data analytics and risk assessment tools to evaluate provider contracts, identify potential risks, and implement proactive solutions.
Records management and HIX support
We provide efficient records management services, streamlined billing, and enhanced financial transparency for providers and patients by designing and integrating comprehensive EHR systems, HIX support platforms, and billing solutions.
Billing and collections
We make healthcare transactions transparent, empowering individuals to manage their own healthcare records, navigate HIX platforms, and understand billing processes.
Network Engagement
Provider management
We build user-friendly digital platforms to foster collaboration with healthcare providers, ensuring seamless care delivery.
Provider credentialing
We develop automated systems to expedite credential verification, ensuring providers meet regulatory standards and quality benchmarks.
Support for PBMs and TPAs
We implement IT solutions to streamline benefits administration and claims processing, improving management of pharmacy benefits and third-party services.
Records management
We design reliable and easily accessible HER systems for secure data storage, helping drive informed decision-making and record management.
Care Engagement
Disease management
We empower patients to manage their chronic conditions and improve their quality of life by creating personalized digital platforms such as mobile apps and remote monitoring devices.
Utilization management
We improve patient care, reduce costs, and enhance operational efficiency with data analytics and automation.
Population health management
We enable proactive health management and improved patient outcomes by analyzing diverse health data to identify trends and disparities.
Claims Engagement
Initial claims management
We ensure accuracy and efficiency in claims management by developing an intuitive, automated validation process to streamline claims documentation and submission.
Claims adjudication and disbursement
We offer fast, accurate, and secure claims processing and provider reimbursement with advanced algorithms and systems that adhere to industry and regulatory standards.
Fraud detection and management
We deliver integrity and compliance across your ecosystem with real-time monitoring systems that detect and mitigate fraudulent activities in claims.
Claims litigation recovery/
subrogation
We optimize financial outcomes for payers and insurers with digital platforms that streamline claims litigation recovery and subrogation processes.
Risk & Compliance
Risk management
We offer regulatory compliance and patient data security by identifying, assessing, and developing analytics models to forecast and proactively manage risk.
HEDIS & STAR rating support
We improve healthcare quality and member satisfaction with data integration platforms that ensure accurate reporting for HEDIS and STAR ratings.
Internal/external reporting
We help you capture real-time reporting and timely submission of regulatory reports and compliance with external parties by creating a customized dashboard.
Compliance management
We ensure adherence to regulatory standards and minimize compliance risks with compliance management solutions that efficiently track, manage, and correct deviations using audit trails and monitoring tools.
Our solutions
Patient Life Cycle Management
Our smart Patient Life Cycle Management solutions enable payers to manage all aspects of payer-provider relationships easily. Providers can also simplify their data management, helping payers easily grow their provider network while delivering better experiences.
Business Process Management
Our Business Process Management includes backend financial processes such as accounts payable and receivable services.
Digital Enablement
Our digital enablement patient-facing services include onboarding, claims handling, managing patients’ feedback, and collection.
Regulatory Compliance Services
Our team of experts helps you identify and maintain 21 CFR Part 11 Compliance including software quality assurance for IT compliance, data privacy, and SOX.
