Healthcare Business Solutions Health Plan Administration Services Modernize your end-to-end operations with one, trusted partner Connect with us × Delivering for our clients at scale 800M claims processed annually 99.8%+ claims accuracy 9/10 top health insurance company partners Unlock your operational agility Legacy systems, regulations, manual processes and data security all make it difficult for small to mid-sized health plans to compete. Our comprehensive suite of solutions empower health plans to manage daily operations at scale. With advanced technology, time-tested processes and a global team of experts, health plans will be equipped to expand business and concentrate on what matters most – their members. *Source: Journal of the American Medical Association Reduce abrasion Deliver fast, accurate provider payments that help build strong provider relationships. Drive engagement Enroll and engage with members across their healthcare journey for healthier outcomes. Maximize efficiency Boost claims automation and accuracy with streamlined workflows and user-friendly interfaces. One partner for a range of needs Every day, we help industry-leading health plans reduce costs, enhance security and create better outcomes for their members, employees and communities – serving as a trusted advisor across your entire healthcare value chain. Leader in NelsonHall Healthcare Payer Operational Transformation Assessment 2024 Designated as a “Leader” based on strong core offerings for government and commercial health plans, including Medicare Advantage, and strong capabilities in automation of enrollment processing and document digitization. Learn more Leader in Everest Healthcare Payer Operations PEAK Matrix Assessment 2023 Recognized for supporting the healthcare payer value chain with innovative solutions that span member engagement, care management, claims management and risk & compliance. Learn more Leader in Everest Group PEAK Assessment of Healthcare CXM Service Providers 2022 Recognized as a "Leader" in Everest Group’s inaugural report in the top three of the highest performing categories: Market Adoption, Portfolio Mix and Value Delivered. Learn more
Leader in NelsonHall Healthcare Payer Operational Transformation Assessment 2024 Designated as a “Leader” based on strong core offerings for government and commercial health plans, including Medicare Advantage, and strong capabilities in automation of enrollment processing and document digitization. Learn more
Leader in Everest Healthcare Payer Operations PEAK Matrix Assessment 2023 Recognized for supporting the healthcare payer value chain with innovative solutions that span member engagement, care management, claims management and risk & compliance. Learn more
Leader in Everest Group PEAK Assessment of Healthcare CXM Service Providers 2022 Recognized as a "Leader" in Everest Group’s inaugural report in the top three of the highest performing categories: Market Adoption, Portfolio Mix and Value Delivered. Learn more
Claims Intake and Automation Ensure faster claims resolutions and better overall outcomes with AI, ML and automation that streamlines submissions and ensures accuracy. Learn more
Member Enrollment and Billing Tap into our suite of solutions to streamline your application process, enroll members faster and enhance underwriting — all while reducing costs. Learn more
Claims Administration Automate and optimize the claims lifecycle with our HSP Core Administration platform, featuring modular architecture and user-defined rules. Learn More
Payment Integrity Identify and recover more overpayments while minimizing abrasion with advanced technology that combines multiple data sources. Learn more
Care Coordination Improve care quality and control medical costs with our member care coordination team providing support and guidance on your members’ healthcare journey. Learn more
Provider Data Management Automate validation, streamline workflows and enhance provider engagement with live support from a centralized center of excellence. Learn more
Three key strategies for small to mid-sized healthcare payers in the Medicare Advantage market Read the blog