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Improve Your Claim and Care Management
Healthcare Payer Solutions
AI-powered payer operations that lower costs, reduce complexity, and improve member experiences.
AI-powered payer operations that lower costs, reduce complexity, and improve member experiences.
A healthcare payer solutions partner with proven healthcare expertise, Hexaware modernizes member engagement, claims, data, and core payer operations through AI, automation, and cloud platforms.
How Do Health Plans Optimize Operational Efficiency and Member Experience
Health plans optimize operations by modernizing core systems, automating claims and workflows, and using AI and analytics to personalize member engagement. Hexaware combines payer expertise, AI, automation, cloud, and analytics to reduce complexity, improve compliance, lower costs, and enhance member experiences.
360° patient insights
Truly personalized healthcare starts with a complete understanding of every member. Hexaware enhances care management and improves health outcomes by harnessing advanced data collection and analysis across diverse sources — clinical, behavioral, and social. This holistic 360-degree perspective on members enables more effective, targeted healthcare interventions, empowering payers to move beyond reactive care toward proactive, data-driven health management that drives measurable outcomes.
Payer data and analytics
Hexaware’s Amaze® platform accelerates payer data migration to cloud warehouses at minimal risk and expense, ensuring seamless modernization of data and BI/AI architecture. Our integrated data management solution facilitates smooth data flow between legacy and modern systems, eliminating silos and reducing operational complexity. We empower healthcare payers with real-time, actionable intelligence, helping them attain strategic goals and deliver superior end-user experiences at scale.
Intelligent Automation
In today’s healthcare landscape, operational efficiency is no longer optional — it is a competitive imperative. Hexaware’s automation platform, Tensai®, empowers payers to automate complex back-office processes, dramatically reducing time, costs, and manual effort. By eliminating repetitive tasks and streamlining workflows end-to-end, Tensai® frees your teams to focus on core business priorities — accelerating transformation and delivering greater value across the entire payer ecosystem.
Hexaware’s customizable CRM helps track all interactions with members, non-members, and providers while capturing member sentiments and values across their journey for improving member engagement. Personalized communications using new-age channels like GenAI-driven chatbots, Alexa, and more, help to improve customer satisfaction.
Traditional application migration can span over six months, incurring substantial costs and associated risks, often without any guarantee of success. Hexaware’s Amaze® offers automated refactoring that drastically reduces the migration timeframe to just 4-6 weeks, making it a more efficient and reliable solution.
Hexaware integrates disparate systems with scalable technology management and enterprise-wide analytics. Flexible architectures enable real-time integration across internal and external systems, lowering the total cost of operations. Our metrics-driven methodology baselines key processes to ensure efficient healthcare payer automation.
Assesses and shifts decades of on-premises legacy payer data to the cloud at the lowest risk and expense with minimal downtime while modernizing data and BI/AI architecture.
Improves member retention, increases enrollment, influences member behavior, and reinforces omnichannel engagement strategies for improved health outcomes and better affordability of care.
Mitigates digital transformation risks, expedites data warehouse development, and provides end-to-end automation for data operations.
Vinod Tekkale
Leader
Healthcare Providers
Enhance patient care, optimize workflows, and adapt to evolving healthcare demands.
Healthcare payers improve member experience by connecting digital engagement, personalized communications, and omnichannel support with core payer systems. AI, CRM, and analytics help deliver seamless interactions, improve member satisfaction, and strengthen long-term engagement.
Healthcare payers automate claims processing using AI, intelligent workflows, and back-office automation to reduce manual effort, accelerate processing, and lower costs. Intelligent automation also improves operational efficiency and enables teams to focus on higher-value activities.
Healthcare payers strengthen compliance through integrated data, analytics, automated reporting, and standardized workflows. Modern payer platforms improve data accuracy, support regulatory requirements, and provide the visibility needed to adapt to evolving value-based care models.
Yes. Healthcare payers can modernize core systems using phased cloud migration, API integration, and automated modernization tools. This minimizes operational risk, reduces downtime, and helps maintain uninterrupted member services throughout the transition.
Healthcare payers use AI, analytics, and integrated clinical, behavioral, and social data to identify care gaps, personalize interventions, and improve population health. Real-time insights enable proactive care management and better health outcomes.
Healthcare payers should look for established IT partners like Hexaware with deep payer expertise, AI, cloud, automation, data modernization, and proven delivery capabilities. The right technology partner should simplify transformation, reduce operational complexity, ensure compliance, and improve member outcomes.
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