Service

Business Process as a Service

A comprehensive, flexible solution for health plans that want to modernize their operations and accelerate their transition to a value-based environment.

SpeedYour Transition to Value

  • Modernize business operations with contemporary, integrated technology. Our offering is built upon a next-generation benefits administration and claims processing platform that supports CMS compliance for all lines of business.
  • Enable lower costs and improve quality with an integrated suite of advanced analytics, care management, and evidence-based clinical decision support solutions. This helps your team engage members across the entire continuum of care.
  • Reduce the risk of innovation. Our BPaaS platform and expertise helps you avoid compromising current operations and reduces the financial risk of implementing growth initiatives. You’ll also gain the agility to take advantage of new opportunities.
  • Identify new revenue opportunities and optimize profitability of government programs using rich analytics, AI, and machine-learning solutions and services.
  • Develop benefit and reimbursement models that reward value. BPaaS allows you to integrate highly customized models to offer groups, members, and providers a path to full-risk arrangements.
  • Engage a flexible, utility-based business model designed to scale with your organization. A single predictable per-member/per-month fee includes all platform technology, support, and business services.

Leverage Our Platform and Expertise

  • Our innovative platform optimizes

    • Benefits administration for all lines of business
    • Care management
    • Medicare enrollment
    • Value-based payments
    • Risk and quality analytics
    • Payment communications
    • Intelligent Healthcare Network™ Services
  • Our team’s operational expertise includes

    • Licensed TPA
    • Eligibility and enrollment
    • Provider network management
    • Claims processing
    • Customer service
    • Platform operations and management
    • Consulting services
  • We leverage our clinical expertise

    • URAC accredited
    • Utilization management
    • Care management
    • Clinical transformation support
    • Provider outreach
    • Custom episode creation and evaluation
    • Consulting services

Our outcomes

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