Payers (Health Plans)

Payers need to retain the low cost, high quality and optimal experience for their members by helping them navigate through health care choices, schedule appointments, manage prior authorizations and connect to provider care teams through automated business processes. Our business friendly IT solutions and services allow payers to achieve this through:

  • Web Portals – For Plan Members, Providers, Labs, Employers and Brokers, providing 24×7 real time and personalized web access to facilitate engagement and decision making
  • Testing (QA) Services – Includes setting up of test framework, test strategies, automation, reusability and execution of large test cases for Payer backend systems
  • Healthcare Plan Administration – For effective claims administration, workflow and document management
  • Care Integration Services – To improve member experience and operational efficiency
  • Care Management – Data driven health risk prediction for effective care coordination and case management
  • Benefit Design – Structure health insurance plans and determine how members can gain access to service and providers
  • Enrolment Management – Online, manual or EDI-based enrolment of plan members
  • Regulatory and Compliance Reporting – For ensuring the adherence and compliance to Federal and State health care laws and regulations
  • Risk and Contract Management – For tracking, simplifying and streamlining the contract life cycle process thus minimizing risks of non-compliance, missed deadlines for audits and contracts being mismanaged
  • Claims Management – For billing, filing, updating and processing of medical claims
  • Member/Consumer Engagement – Through adoption of mobile apps, enhanced self-service features, easy access to real time data, reduce call volumes and more

 

Providers (Health System)

As a niche Healthcare IT services provider, our expertise spans end-to-end Project Management and on-demand IT consulting with a team of solution architects and SMEs for integrations, upgrades, configuration and QA for:

  • Admission, Discharge and Transfer (ADT)
  • Billing – Payment Integrity, Payment Posting/Reconciliation
  • Centralized Documentation Indexing/Sorting
  • Claim Status
  • Coordination of Benefits (COBs) and Explanation of Benefits (EOBs)
  • Data – Governance, Ingestion, Warehouse, Orchestrations, business intelligence and Disaster Recovery solutions
  • Eligibility Status Checking
  • EMR/ EHR – Integration & Testing
  • Cloud Solutions (Infrastructure) – Traditional and hybrid cloud services that are secure, reliable, scalable and compatible with healthcare regulations
  • End User Support (Infrastructure) – Help Desk, Clinical Help Desk, Remote monitoring of devices/endpoints, IOT
  • Digital Hospital Wayfinder with conversational AI (portal)
  • Prior Authorizations (PA)
  • QA – Testing
  • Revenue Integrity – Charge Capture Reviews
  • Security – Network and data security with firewalls, anti-intrusions systems, pen testing, cyber command

 

Pharma (Life Sciences)

Pharma, life sciences and biotech organizations need to schedule, capture and control data from clinical trials easily and efficiently. Our capabilities address the unique needs of each organization based on the requirements of clinical teams, statistical consultants and regulatory requirements with our:

  • Clinical Trial Solutions
  • Data Solutions
  • ERP Solutions
  • Track & Trace Solutions

 

Products (Health ISVs)

ITC Infotech works with leading ISVs to provide enterprise solutions around hosting, CRM, content management, electronic health records, etc., that include:

  • Cloud – MS Azure & AWS
  • CRM – SFDC (Health Cloud) & PEGA
  • DMS – Hyland OnBase & MS SharePoint
  • EMR – Cerner & Allscripts
  • ERP – SAP HANA
  • ITSM – ServiceNow & BMC Remedy
  • Planning – Anaplan

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