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Health Plans

We provide health plans with consulting services that support functions such as:

  • Claims eligibility
  • Provider enrollment
  • Benefits
  • Care management
  • Customer support

Health plans are expected to take a leadership role when it comes to improving healthcare quality and controlling costs. They are also expected to comply with numerous federal and state regulations, as well as accreditation standards. Navigating this ever-changing environment can be a complex undertaking, so health plans look to our consulting team for added expertise and support for their health information technology initiatives.

Our services help our clients maximize cost efficiencies and increase timeliness of claims payments, reimbursements for proper procedures and diagnoses, reporting quality, and member and provider satisfaction.

Success Story

Our consulting team worked with a large multi-state health plan to complete a detailed assessment of its centralized claims operations.

We used the results of the assessment to implement an extensive systems and business operations improvement plan that enhanced their business operations and optimized the use of their health IT.