Healthcare Payer Services

Hexaware brings in deep domain expertise in claims management services using processes that are compliant to global standards. Our processes leverage the use of home grown automation that have been incorporated on large scale client engagements. By making use of our Payer solutions, you will be able to create digital member engagement and other aspects that are critical to your business growth.

Our solution works collaboratively with social media to stop revenue leakages that may result from inflated claims billing. Intelligent and robust reporting structure provides 360 degree view of your entire claims function.

Key Benefits

  • Improve the accuracy of data during the pre-adjudication and adjudication process
  • Improve process compliance by reducing frauds
  • Enable continued enhancements by reducing claim overpayments, revenue leakages and turn around
  • Harness deep domain expertise and best practices from the Provider
  • Helps you focus on your core objectives and free up critical resources
  • Innovation through technology enablement can significantly reduce your total cost
  • Robotic Process Automation helps you eradicate the costly, human-capital intensive processes that have long been associated with claims processing
  • Claim analytics provides timely access to relevant data and consolidated view of information to help organizations to measure, monitor and manage KPIs across the claims life cycle

Service Spectrum

Customer Research and Product Creation

Sales and Marketing

Policy Acquisition

Policy Servicing

Billing and Collections

Claims Processing

Insurance Accounts and Regulatory Reporting

Customer segmentation

Product design

Actuarial services

Regulatory approval

Background research and analytics

Distribution channel management

Direct sales

Outbound / Inbound

Telesales

Marketing and Advertising

Obtain and validate

Risk details

Policy validations

Premium calculations

Policy authorizations

Prepare and issue policy

Customer query handling

New business data entry

Maturity processing

Servicing for loans, surrenders and lapsation

Inbound call center

Capture and index queries and complaints

Update database

Prepare and send response

Refunds

Exception handling

Record remittance

Collect premiums

Produce bill statements

Reconciliations of bulk premiums

Handle billing queries

Payment processing

Assessment litigation

Complex claims assessments

Recovery of overpayments

Index claims

Register claims

Claims validation

Settlement

Invoice

Processing claims invoices

Generate reports for regulatory agencies

Tax processing

Payment processing

Bank reconciliations

 



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