Solutions for Payers

Solutions that help address strategic priorities and navigate trends, such as consumerism and value-based care.

Transform.Financial and Clinical Outcomes and Consumer Experiences.

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Information sharing for better care coordination, risk analysis, and network management

  • Automate provider contracts to help reduce costs and improve efficiency
  • Engage members and measure quality to support satisfactory care
  • Speed your transition to value to help improve patient outcomes
  • Analyze and automate value-based models to scale complex payment processes

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Manage medical costs and collaborate with providers for better outcomes

  • Use evidence-based decision support to support appropriate care
  • Solve clinical and technical IT challenges to optimize your business performance
  • Ease medical-records retrieval and clinical review to help improve risk adjustment and quality scores 

Grow.Drive Cost Control and Revenue Enhancement.

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Streamlined payment efficiency for improved accuracy and revenue performance

  • Process claims faster to make operations more efficient
  • Improve payment integrity and transparency
  • Tap experienced consultants to solve clinical and technical challenges

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Healthcare payer solutions for optimized provider networks

  • Use our nationwide connectivity to streamline engagement and claims processing
  • Enable pharmacy benefits administration to optimize member experiences and financial outcomes
  • Convert to e-payments to lower reimbursement-distribution costs
  • Achieve accurate, risk-adjusted payments to meet compliance and quality goals

Empower.Provide Members with Tools and Services to Support Their Healthcare Journey.

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A comprehensive selection of tools to enable exceptional member experiences.

  • Offer a consumer-solution suite to improve member experiences and satisfaction
  • Boost use of your member portal to better engage consumers

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Enrollment- and billing-management solutions for enhanced member engagement

  • Offer payment counseling to support financially vulnerable patients
  • Provide provider search and cost-comparison shopping tools to help members find care

Our outcomes

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