Core Health Plan Services

We work with leading payers to increase productivity, create more efficient processes, and harness the power of data to improve healthcare outcomes

Digital Services

Plan Administration

Syntel delivers end-to-end plan administration services, including core plan implementation, upgrade and support. We employ a robust suite of tools and accelerators that help derive more value from your core admin platform investments and reduce TCO.

Care Management

We employ an approach to Care Management that integrates processes and IT platforms to enhance the quality of care with greater accountability.

Product Consulting

Supported by strategic partnerships with leading product companies like HealthEdge,  Syntel employs IT modernization and process automation techniques to accelerate adoption and drive higher ROI across leading Core Administration and Care Management platforms for our clients.

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Accountable Care

Syntel’s services for Accountable Care Organizations (ACO) measure and track the entire healthcare value chain, including the cost and quality of care. Our solutions include:

  • Electronic health record (EHR) and electronic medical record (EMR) data integration 
  • Data aggregation 
  • Clinical analytics and business intelligence
  • Performance and financial reporting framework
  • Performance-based reward/incentive program for providers
  • ACO contract management and claim processing KPO services 
  • End-to-end testing

Patient Privacy

Ensure data security, regulatory compliance and protect customer privacy with Syntel’s Protected Health Information (PHI) masking solutions. We employ the latest data management techniques to mask and scramble sensitive information in order to ensure data integrity and optimal system performance.

Claims Adjudication

Implement real-time adjudication to assess, plan and implement system enhancements. Syntel has successfully enabled real-time claim adjudication for leading payer organizations, dramatically decreasing turnaround time.

Claims Analytics

Syntel’s Claims Reporting and Analytics framework employs Key Performance Indicators (KPIs), dashboards and industry-standard data models to analyze medical claims, assesses risk, improve processes and drive informed decision making.

Value Based Insurance Design

Syntel’s Value Based Insurance Design (VBID) solutions help combat the escalating cost of care and improve patient outcomes with incentives, rewards and an intelligent cost-sharing system for healthcare services.

Pharmacy Benefit Management (PBM)

Syntel’s PBM Dashboard tracks generic, branded and specialty drug utilization over time, to give pharmacy benefit managers accurate, actionable information to support informed decision-making.

Claims Overpayment Detection

Detect incorrect claim payments with Syntel’s Claims Overpayment Detection Solution (CODS). Using next-generation analytics, we can help you detect overpayments that have gone out, and use this knowledge to anticipate and proactively address future overpayments.

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