Health Plan Administration and Customer Care Solutions
Sure, today’s health plan administration challenges include items such as eligibility, claim status and benefit applications. But, in a consumer-centric, customer driven environment, it is imperative for healthcare payer organizations to be engaging members with personalized two- way communication where customers drive selection, pricing and choice of coverage.
To navigate this challenging new healthcare landscape, Conduent’s innovative solutions and our 10,000+ dedicated Payer agents provide health payers with administrative tools that drive better business outcomes, including:
- Benefits Plan, Explanation and Verification
- Claims Processing, Payment and Status
- Enrollment and Membership
- Eligibility Verification
- Premium Billing
- Provider Networks and Contracts
- Capitation
- Authorization and Referrals
- Enterprise-Wide Workflow
- Security
- Reporting & Analytics
- Complaints and Appeals
- Disease Management Programs
- Health and Wellness Programs
- Licensed Agent Customer Care Services
- Missing/Invalid Information Research
- Product/Services Information
- Referral Requests and Status
- Satisfaction Surveys
- Welcome Calls
Conduent is also a leading-edge provider of intelligent automation technology services, including:
- Virtual Assistant – Automated voice assistance which recognizes complex, contextual, and abstract vocal inquiries.
- Machine Learning – Cognitive learning platform that analyses data to develop the intelligence it needs to understand, diagnose, and solve problems in real-time
- Interactive Voice Response (IVR)
- State-of-the-Art Computer Telephony Interface (CTI)
- Customer Relationship Management (CRM)
- Advanced Switch/Multiple Platform Integration Solutions