Healthcare Payer Business Solutions

New healthcare IT systems which have the capacity to support the delivery of high quality care and enhanced patient satisfaction have been implemented by the industry. These IT systems also allow for streamlined workflow processes, secure information sharing and data integration throughout the enterprise. This technology tackles a variety of obstacles which include U.S government requirements for the implementation of Electronic Health Records (EHR), delivering accountable care and the improvement of patient information access.

Expert Business Consulting is on the forefront of healthcare payer solutions, the offerings are:

Customer Enrollments

Our Customer Enrollment solution permits healthcare payers to reduce the enrollment cost and raise competency.

Rating and Underwriting

EBC’s healthcare business solutions also assists the payers in handling exclusions, denials, preexisting conditions and premium calculation for its members.

Policy Administration

The Core Policy Administration service that we offer aids in supplying great customer service and healthcare policy administration at a lower costs to payers’ members/customers. Moreover, it decreases manual activity and boosts data upkeep and veracity.

Benefits Validation

Automate the tedious manual benefits validation process with EBC’s healthcare business solution. Members, internal processing staff and providers can count on an integrated platform for communication. This platform simplifies the convoluted business processes.

Claims Management

EBC’s solutions allows healthcare payer organizations to supervise the claims life cycle, from provider submission to claims readjudication.

Health Insurance Exchange

We have success in developing private health insurance exchanges using our experience in healthcare, technology and administration.

Clinical Data Integration

Our clinical data integration team integrates differing external administrative and clinical data streams with administrative information, financial information and internal clinical intelligence.

Customer Relationships Management

Action oriented customer data can differentiate the healthcare payers from their potential competitors. We suggest payers to invest money to get good results, while positioning themselves for long term results.

Portal Solutions

Private portals increases essential connectivity: providers, employers, administrators, brokers and members will have their constituent connectivity improved through two way interactivity. Self service transactions and information downloads can all be performed by customer constituents.