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Health Plan Administration and Customer Care Solutions

HSP Customer Service Portal

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