healthcare it solutions for payers

Payers

US healthcare payer environment has been subjected to waves of changes in the form of ICD10|5010, HEDIS reporting, VBC, MCO transition and many others. Owing to the nature of their business, most payers were among early technology adopters within the US healthcare ecosystem. However, due to contextual and technology changes in the environment around them, they are forced to make large scale changes to their IT systems. Sitting on a wealth of data, they are also well positioned to leverage this data to improve care quality, lower premiums, drive better consumer health and eventually better profitability. We help in achieving your business goals via different ways employing the optimal use of technology.

Below are a few areas we excel in and can bring new ideas on the table if these happen to be critical for you currently.

Member management &
engagement
  • Claims
    management
  • Population
    health
    Care
    management

    How do we help you?

    • Integrate various sources for Clinical, Financial, Administrative, Consumer and operations data using standards such as FHIR, HL7, EDI
    • Aggregation, segregation, classification and management of data using EDW, Data marts etc.
    • Deductive and predictive analysis of data for scientific decision making
    • Meaningful presentation to enable quick business decisions using dashboards and self-service reporting
    • Support existing applications (even legacy ones - AS400, Delphi, VB etc.)
    • Document and reverse engineer legacy solutions
    • Build wrapper applications to provide a modern user experience yet maintaining the robust, time-tested back-end
    • Provide SLA bound sunset support
    • Architect, Design and develop solutions using modern technologies
    • Technology migration of solutions without much documentation
    • Migrate/Extend existing applications to cloud/mobile
    • Perform independent validation and verification of developed solutions
    • Uplift/Enhance User experience of existing solutions
    • Identify, Stratify, Classify and positively impact the health of high-risk members through well designed population health management solutions
    • Successfully use and report Clinical Quality Measures (CQM) data for HEDIS, Star etc.
    • Manage your provider networks and contracts to maximize quality ratings and your bottom-line
    • Benchmark performance and Identify instances of fraud, gaps in processes, provider relationships that are making you bleed
    • Increase consumer health awareness by integrating better with provider systems
    • Ensure consumer participation in your outreach programs through professional CRM initiatives
    • Enhance your reach through mobile solutions and gain more consumer eyeballs to drive preventive measures
    • Listen better to your members by tracking their actions through ‘Internet of Things’ (IoT) enabled devices

    Explore and read up

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