When auto-adjudication enables faster claim processing, thereby making customers happy,

it’s #Digitaligence at work!

As the health care industry continues to transform, managing change is becoming more complex. Companies need to streamline member enrollment and accelerate claims-processing. This is leading to automation, electronic enrollment, rule-driven product configuration and auto-adjudication of claims by many health insurance core admin platforms available in the market.

ITC Infotech’s Center of Competency (CoC) across traditional as well as next generation core admin platforms like Facets, QNXT and HealthRules, coupled with in-depth expertise in payer business processes, enable us to offer cost-effective and quality services across application development, maintenance, configuration, testing and BPO.

Core Platform Surround Services

DELIVERING RESULTS

  • Upgrade services: End-to-end product upgrades and remediation of custom interfaces
  • Configuration services: Experienced in configuring product pricing and claim rules; application, batch and letter server; interface, EDI gateway
  • Ancillary application development services: Integration interface on BizTalk, TIBCO and WebSphere; custom extracts & extensions to different subsystems; web portal on real-time EDI transactions and customer engagement; report, dashboard, data mart/DWH, data conversion, ETL
  • Testing services: End-to-end QA, TCOE set-up and TaaS
  • Business process reengineering services: BPM of membership pre-enrollment, provider enrollment, rating, claim submission and claim editing, and rule engine migration
  • BPO: Manual processing of pending claims, auditing claims and providing member and provider contact center

Business benefits

  • Faster time-to-market for payer organizations
  • Ongoing cost optimization
  • Streamlined and efficient IT operations

RESOURCES

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#Digitaligence

$9.5 tr

The forecast for net global healthcare expenditure by 2018

83%

Consumers willing to share their medical records with a health system in order to aid in their own diagnosis and treatment

40 years

Age of technology used to manage claims process by many insurers - hindering innovation

Put #Digitaligence to work for you. Get in touch with us now!

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