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Payors

Driving Value-Based Care Models and
Enhancing Member and Patient
Experience

Overview

With rapid technological advancements and constantly evolving standards in healthcare, payers are faced with the challenges of integrating disparate systems and processes that do not fully address stakeholder needs. We empower payers to significantly improve member experience, and provider, broker relationships with technology services that address these gaps.

Focus Areas

Digital Front Door/ Conversational
Assistants

We help engineer Al chatbots for our customers to enable them to connect with the providers and members they serve using new-age technologies and provide them with engaging experiences. This helps payers address customer expectations, enhance the quality of conversations and their overall experience.

Core Platform Modernization
(Enrolment, Billing, Claims)

Our core platform modernization services help payers bring tremendous flexibility and novelty in their health plan offerings and surge ahead of the competition. Our design philosophy and technologies are aligned with and tailored to business strategy and help healthcare payers establish a strong digital foundation.

Portal and Mobile App
Development

Our portal and mobile app development services for payers enable the shift towards value-based care by delivering enhanced engagement experiences to the provider community and member population. The services are geared towards delivering improved clinical outcomes.

Ancillary System
Modernization

With technology advancements on the provider side and other parts of the healthcare ecosystem, it is imperative to modernize technological systems in diagnostic services, therapeutic care, and care delivery (or custodial services). Our consulting and services in the space of integration, application modernization and support, digital modernization and transformation, application engineering, and health cloud enablement help organizations improve overall member experience and optimize internal operations.

Data Migration and Enterprise
Data Lake

Our data modernization services ensure that enterprise data is interpreted and leveraged to achieve operational and population health excellence. In addition, our blockchain-based framework helps organizations improve data quality and speed up data processing.

IoT/IoMT
Integration

Our IoT/IoMT services enable payers to build connected health programs, resulting in the integration of disparate systems and data. The services help improve the bottom line through overall efficiencies in core payer processes like risk calculation, claims, billing, and enablement of preventative care.

FHIR
Implementation

We simplify the complex process of achieving compliance with interoperability standards through our specialized engineering services. Our expertise includes implementing data and security policies aligned with HL7 FHIR standards and delivering reintegration and remediation of data feeds, enabling seamless integration across healthcare systems.

Predictive Analytics for
Member Engagement

Our AI tools, frameworks, and AI/ML expertise empower payers with better understanding of their members and providers through advanced data analytics. We help with evaluation of current member experience strategy, analytics on customer journeys and longitudinal health records, which enable payers to offer exceptional value to their customers.

Population Health
Analytics

Population health analytics is a critical requirement for players in the healthcare ecosystem. We have extensive experience in handling and consolidating large datasets to gather actionable insights. Our experience and frameworks leverage datasets to show the complete picture of population health management, revealing patterns and trends. This helps organizations predict disease outbreaks, analyze outcomes, and in turn improve service levels.

Bundled Payment and
Contract Management

We provide AI engineering services that help payers assess how claims will behave in an episode of care or bundled payment contract, significantly reducing risk. Our services enable payers to estimate ROI with greater accuracy and make data-driven decisions during critical processes such as contracting and attribution.

Operational and
Financial Intelligence

Our services across the financial value chain – capitation management, billing, claims payable, and corporate financials, help payers optimize operations and maximize their ROI by providing actionable insights on the operational and financial aspects.

Success Stories

Insights and Trends

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