Healthcare Payer

Improve claims management & data interoperability

Improving member experience, eliminating the gaps in claims management, making payer-provider data exchange seamless are the challenges of healthcare providers – which we focus on solving through our below offerings.

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Healthcare Insurance Segments We Serve

Health Plans

Developed 360- degree member management view for employer health plan

Managed Care

Automated pre-authorization process during payer-provider collaboration

Third Party Administrators

Provided data extraction, transformation & loading services

Speciality Payers

Transformed traditional EDI to FHIR APIs improving network protection

Blue Cross & Blue Shield

Built custom member management solutions for BCBS

Healthcare Insurance Segments We Serve

We assess your digital maturity and help you withstand competition and serve members better.

Our Offerings for Healthcare Payer

Claims Management System Modernization

Modernize or replace claims systems for lesser TCO, effortless plan configuration, batch processing, real- time data exchange and better user experience.

Trizetto Facets Maintenance

Support Facets system by version upgrades, batch operations management, error handling, data configuration, migration via scripts, production support and testing.

CRM & Call Center Solution Design

Design an NLP driven call centre CRM & analytics platform to automate thousands of member queries and update the peripheral LOB systems without manual effort.

Healthcare Interoperability

Implement health information exchange defined private, centralized, decentralized, hybrid – data & network architectures, APIs following FHIR HL7 standards.

Data Integration & Insights

Member, provider, network, health plan, claim, website, customer service portal & IVR’s transactional source of truth databases & warehouses creation

Population Health Management

Build custom cloud- native analytics & point-of-care workflow platforms and integrate with EHR, private & public geospatial data sources.

Intelligent Automation

Automate manual error-prone claims administrative tasks like data capture then feed into different LOB systems using OCR + RPA technologies

AI at your service

Develop AI-powered intelligent virtual agents (IVAs), health plan recommendation models, claim adjustment tools, complaints & sentiment analysis. Our Coverage in Digitizing Front, Middle & Back Office Tasks