Industry Trends

Health insurance payers implement 'packaged core administration solution' to support their business functions of membership, billing, network management, claim, utilization and customer service. The latest healthcare payer trends recommend:

• Upgrade packaged core admin and other enterprise applications to achieve ICD 10 - 5010 compliance deadline
• Add flexibility in product-benefit design following Healthcare Reform requirements
• Build guided sale solutions and customer self service portals to participate in Health Insurance Exchange
• Maintain an integrated testing infrastructure that cuts across diversified IT applications
• Improve business process integration of underwriting, enrollment, pricing, claim administration and payment

How Wipro Helps

Wipro's Healthcare Payer practice has set up Payer Product Service and Solution Centre, to support the healthcare payer's journey to consumer centric health while accomplishing business initiatives like regulatory compliance, technology modernization and information transparency.

• Configuration Services
  Business rule configuration services in product/benefit, pricing, provider reimbursement, capitation, group/member premium. Configuration of batch and letter servers
• Testing Services
  Functional, prototype, ITS, integration, regression, batch-patch, performance and user acceptance testing services dedicated to the 'packaged core admin solution'
• Upgrade Services
  Upgrade scoping and planning, impact assessment, remediation and testing, bundled with ICD 10 - 5010 conversion service offerings.
• Application Development Services
  EAI services to develop EDI, self services/sales portal, interface, extract, BI reports and analytics solutions
• Infrastructure Management
  Manage operations of batch jobs, interfaces, extracts and reports, maintain and support servers and databases and perform ITIL management services for the 'packaged core admin' and other enterprise applications.