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Payer Value Chain – Solutions & Frameworks

Overview

Infosys has strong capabilities in Health care solutions and Strategic Frameworks across the Payer value chain. The Solutions are spread across the value chain as in Plan design & Sales, Member & Provider engagement, Care Management, Claims Processing, Customer Service and Business Operations Management.

The Strategy frameworks & consulting includes Playbook for product implementation, BPM assessment across healthcare domains viz Claims processing, Care Management etc. It also includes Frameworks for Plan set ups, KPI Assessment, Member Impact assessment to name a few.

Infosys outclasses in healthcare solutions and strategic frameworks across the payer value chain, enabling automation, savings, and modernization.

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Infosys knowledge and expertise in the Healthcare solutions & Strategic Frameworks has helped client organizations with automation of various processes as in Sales process, Provider Ingestion, Benefits configuration reviews. These automations have resulted in huge savings and optimization as well as easy of maintenance of the existing processes and functions. The consulting & strategic framework has helped client organizations with Assessment of their various business processes frameworks like Provider data management, Care management , claims processing etc. which helped in improving and modernizing existing business processes to build a more robust and flexible system and functions.

Challenges & Solutions

Existing processes are old and not easy to maintain and scale and often cause bottlenecks, Process Frameworks and automation helps with improvement of existing processes to make them more efficient and flexible. Solutions using automation frameworks has helped improve sales processes, provider roster ingestion resulting in overall process and function optimization & quick turnaround.

Existing business operations & processes needs to be assessed to keep them up to date & relevant as well as ensuring. It also needs to be ensured that latest compliance practices and standards are met and followed. Solutions were developed for client organizations by creating dashboards for reporting and compliance management thus making the process easy to maintain and understand. Automation of Audits & Review process has as well been implemented using frameworks reducing manual touchpoints & interventions and making the overall process smooth & quick.