Deliver a Consumer Experience to Members and Providers

Today’s health plan administrative roles have expanded beyond traditional claims processing, enrolment and payment accuracy. The role of insurance provider has shifted, and the additional role as care provider demands new approaches. You must design products, deliver information and engage with consumers while meeting a myriad of new federal and state regulations. We can help. For more than 30 years, our health plan solutions team has implemented the processes and technologies that bring about real transformation for customers of all sizes.

Our end-to-end health plan services help you streamline operations, improve productivity and strengthen cash flow, allowing you to stay competitive and improve member satisfaction. We provide digital led consumerism experiences with impactful and real-time analytics, automated, intelligent and multi-channel customer support, digital dashboards and access to information through mobile phones, tablets, laptops and desktops. This allows you to focus on strategic initiatives that drive growth and care quality. Utilising our new Digital BPaaS service offering, you can realise value-based outcomes in as little as 90 days.

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Digital Transformation and Cost-Effective Care

In new research, NTT DATA and ISG explore insights to help health plans move to a member-centric model, adapt to new technologies, acquire new skills, enhance outcomes and lower costs – all while improving services and fostering resilience.

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Build a virtual workforce through automation, and take multi-tasking to a new level.

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Our Services

Front Office

We offer a wide range of administrative solutions for health plans, including sales and enrolment call centres and direct marketing.

Middle Office

Lower costs by focusing on improved outcomes with care management, disease management, utilisation management, on-site nurse support and telemedicine.

Back Office

Streamline claims processing, billing, customer service, enrolment and more, and adopt payment integrity solutions that add value.

Everest Group named us a Leader in Payer Digital Services in its PEAK Matrix® Assessment. – February 2020

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Our BPaaS solution for health plans combines expert people, proven processes and cutting-edge technology to drive value-based care.