Payers

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

Digital Services

Offerings

Core Health Plan Services

  • Plan Administration
  • Product Consulting
  • Claims Adjudication
  • Value Based Insurance Design
  • Patient Privacy 
  • Pharmacy Benefit Management
  • Claims Overpayment Detection
  • Care Management
  • Accountable Care Organization (ACO)
     
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Digital Healthcare Services

  • Mobility and Internet of Things (IoT)
  • Healthcare Business Intelligence and Analytics 
  • Legacy Modernization

Government Program Solutions

Reduce administrative costs with efficient, regulatory compliant program administration solutions from Syntel, including:

  • Regulatory Compliance
  • Medicare / Medicaid Program Management 
  • Quality of Care
  • Revenue and Performance Optimization
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Product Services

Health Plans utilizing COTS products for their end to end claims processing platforms include Facets, QNXT, HealthEdge and Pega. Syntel services for the COTS products include:

  • Core Administration – Configuration Services
  • Care Management
  • Consumer Engagement
  • Analytics
  • Integration
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Payer BizOps

Reduce cost, and increase the speed, scalability and accuracy of your business operations with automation-powered BizOps services from Syntel. Our solutions apply rule-based automation, machine learning and predictive analytics to areas such as:

  • Claims processing, adjustments and audit services
  • Member services 
  • Premium processing, reconciliation, and billing services
  • Provider data configuration, Medicare risk adjustment

Success Stories

Agile Transformation at a Leading U.S. Healthcare Payer

The client is a leading healthcare payer that needed to improve time to market in order to meet frequently changing compliance requirements. As a strategic partner, Syntel helped educate the client about the benefits of Agile development and created an distributed Agile model to meet their needs.

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Enhancing Productivity with Syntel’s Production Support Services

A leading health insurance company was facing issues resolving a large number of tickets stemming from recurring issues. The client decided to make a significant effort to fix these errors, so Syntel deployed a team of Kanban and Production Support and Maintenance (PSM) experts to quickly and permanently fix them. In doing so, we not only reduced the ticket count, but also managed to automate a number of time-consuming manual activities.

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