Payers
Amitech Solutions professional team has extensive consulting and industry experience
with payers, leveraging our well defined and disciplined approach to problem solving
to create customized, innovative solutions. Our international, multidisciplinary
perspective enables us to create robust strategies and action plans rapidly for
our clients. In addition, we support efficient, effective implementation of these
strategies. We measure our performance by our success in helping clients advance
their market positions while improving care delivery.
Payer organizations are challenged with pressures of containing costs, enhancing
services, litigation, regulations and benefit mandates, medical fraud, and variations
in practices. In this competitive business environment having an integrated data
management strategy coupled with our deep domain expertise can help you succeed
in aligning actions with business strategy, containing premiums, improving quality
of care, meeting customer expectations, reducing expenses, changing regulations,
and increasing your bottom line with greater operational efficiency.
Payers are under increased pressure to improve the way they do business. But inefficient
business processes, lengthy claims processing and outdated information management
strategies are proving to be formidable roadblocks to making healthcare more affordable,
retaining existing members, acquiring new members, as well as enhancing services
and increasing quality of patient care.
In such an environment, success depends on capturing, integrating, analyzing, and
acting on information at the right time. We have a proven track record in delivering
measurable results for our clients in Payer organizations by solving your complex
information challenges in an increasingly customer-centric environment.
Through working with Payer and Third Party Administrator organizations we’ve proven
that we have a solid understanding of your issues and can turn around innovative
BI and IM solutions quickly to improve your business performance. What’s needed
most is a partner that understands your complex challenges and will help you develop
an intelligence platform that crosses the enterprise by leveraging your data assets.
Our clients benefit from our key capabilities in data integration, which is the
most challenging issue in providing better healthcare and increasing business performance.
We can help you develop and deploy a reliable, accurate, scalable, and integrated
analytics platform leveraging ‘silos of intelligences’ from data related to Employer
groups, Membership, Product, Facility, Provider networks, outcomes and claims, Actuarial,
Underwriting, Human resources, and Marketing and Sales. An integrated platform enables
your organization to manage complex business issues such as cost containment, enhancing
services, litigation, regulatory compliance, benefit mandates, medical fraud, and
sales and marketing performance.
We offer business intelligence, analytics, predictive analytics, performance management,
and information management solutions to improve operational efficiency and business
performance in the following areas:
- Actuarial
- Call centers & Customer Satisfaction
- Channel Management Analysis for Agents & Brokers
- Claims Processing & Adjudication
- Customer intelligence - 360 Degree Member view
- Disease Management & Predictive Modeling
- Early Fraud Detection & Prevention
- Medical Management & Healthcare Informatics
- Operational Intelligence
- Pharmacy Benefit Management Services
- Provider Analysis & Management
- Underwriting Profitability & Inventory Management
- Utilization Review & Quality Management