Transforming Healthcare from the Inside Out

The Challenge

One size never fits all. The healthcare industry is undergoing sweeping changes that are posing unique challenges for every organization. How do you initiate and sustain critical, transformative change in a regulated, highly politicized environment?

Healthcare is our focus. For the past 17+ years, our firm has pioneered change at some of the largest organizations that regulate, manage, and deliver America's healthcare. From digital to data and patient experience to operations, we apply process innovation, industry best practices, and advanced technology to elevate quality and affordability.

Our Healthcare Payer Solutions

Paving the way for a top-notch member experience

Healthcare payers face intense pressure to keep up with consumer-focused industries, abide by changing regulations, and provide value while making sense of an endless volume of data.

We work with healthcare insurers ranging from Fortune 50 behemoths to small, regional payers. Our healthcare payer solutions are customized to each organization's individual needs, but the end result is the same – improve the quality of care and member experience.

Provider Management Tools

- Provider Credentialing for Workflows
- Detecting Fraud with AI
- Provider Incentive Payments

Finance Tools

- Risk Adjustment

Sales & Marketing

- Healthcare Services Marketplace
- Value-Based Contracting

Operations Tools

- Delegating Data Administration
- Supporting Care Coordination by Modernizing 
Legacy Payer Data Warehouses
- Optimizing Call Center Productivity using NLP and AI
- Automating Procurement and Legal Workflow

Enabling Premium Care Delivery Models & Provider Engagement

Providers help their patients face critical decisions on a daily basis. We focus on the business, so you can focus on the patient.

We empower healthcare providers to improve the patient experience from registration and check-in to operational re-engineering and process improvement. In a fast-changing world, we enable adaptation and innovation that improves outcomes, optimizes patient interactions, and increases patient satisfaction. We help providers gain a better grasp on the business side of their practices to reduce administrative burden and optimize the revenue cycle.

Telehealth & Remote Patient Monitoring

Telehealth is here to stay – from video visits to in-app diagnoses, we’re only scratching the surface of what’s possible.

Elderly Care

Senior citizens have unique healthcare needs as they age. We developed monitoring tools to help the elderly population stay safe and comfortable in their home longer without the need of a care facility.

Operations & Cost Reduction

Looking to reduce reliance on insurers? Take on end-to-end operations from customer portals and billing to claims and incentive-based payments with cost-effective, in-house insurance.

Population Health

There’s a strong need for population health initiatives that improve outcomes for patients and ROI for healthcare organizations. We align leadership to their ideal state, identify strategies that yield the greatest impact, and improve ROI by focusing on the right projects.

A hybrid approach to reducing cost and creating predictability.

Third Party Administrators play a prominent role in the healthcare ecosystem. As employers continue to search for the next generation of cost-saving methods for their health insurance needs, they rely on new funding models and innovative arrangements.

Learn more about our solutions designed especially for self-funded employers and TPAs.

Claims Settlement for ASO

Administrative Services Only is a hybrid funding model that combines the cost advantages of self-funding with stop-loss coverage with the payment predictability that’s appealing to small, medium, and large employers alike. The ASO Claims Settlement System is a comprehensive solution that integrates the needs of employers, brokers, sales &marketing, actuarial, and finance operations throughout the contract, settlement, and billing processes.

Finance Tools

- Risk Adjustment

Sales & Marketing

- Healthcare Services Marketplace

TPA Operating Platform

An all-in-one solution to take on end-to-end operations from customer portals and billing to claims and incentive-based payments with cost-effective, in-house insurance.