Healthcare Payer Solutions
A Transformative Partnership
Our approach to healthcare payer digital transformation begins and ends with partnership. With a combined 360+ years of experience working in and for payer organizations, our team understands payer operations and technology and uses that deep knowledge to create intelligent automation, optimize core platforms, and architect end-to-end solutions for clients seeking to enhance digital presence, reduce total cost of ownership, and stay current with fast-changing directives from both internal and external sources.
DIGITAL ENGINEERING FOR HEALTHCARE PAYERS
KEY SOLUTIONS
Cloud-Native Engineering
- Platform Assessment and Cloud Operating Model
- Azure and AWS Platform Migrations
- Next-Gen Facets Strategy and Implementation
- Managed Services – Azure and AWS Deployments
- CAA and Mandate Compliance Solutions
Core Platform Utilization and Performance
- New Feature Utilization
- Performance Dashboards
- Security and Role Management
- Retroactive Activity Automation
- Data Mapping
Claims Automation and Optimization
- First Pass Rate (FPR) Optimization
- Automate Adjustments & Routing
- Quality Audit Automation
- Reduce Claim Adjustment Rates
- Inventory Dashboards
- Claims Testing
Configuration Build and Conversion
- Benefits Configuration
- BPA Conversion and Optimization
- Workflow Configuration
- Configuration Data Cleanup
- PCA Configuration
- Authorization/Referral Configuration
Governance and Change Management
- Change Management
- Leadership and Support Models
- Centers of Excellence
BPO Services
- Claims
- Configuration
A DEDICATED TEAM OF EXPERTS
Expertise
360+ years of Healthcare Payer experience across domains
Values
Collaborate, Innovate, Drive, Serve, and Grow - the values we embody with our colleagues and partners
Outcomes
Client-obsessed to provide quality outcomes and improved, measurable results
Experience
Immersive partnerships with dozens of industry-leading vendors