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Case Study

Member self service portal

Customer

The customer is consistently ranked among the top HMOs in the USA for quality of care. They offer health care in New England area, primarily in Massachusetts. They offer an extensive network of over 24,000 affiliated providers, providers on staff, thousands of independent physician and group practices and 140 hospitals.

Challenge

Payers organization face pressure to deliver new value defined in terms of decreasing healthcare costs and improving customer satisfaction. Member self service portals need integration of the portal with claims system and need to provide a single customer view and experience across customer touch points

Solution

Wipro designed, developed and implemented an enterprise wide portal for consistent customer experience. across touch points. This portal facilitated provider/member self service for claims status inquiry, address updates etc.

The backend systems like claims were also enhanced and integrated to support this portal

Benefits

	The solution brought about large business impact for our customer by reducing load on call center
The web site had
	2000 Claims Enquiry/day
	90,000 Member registrations
	200 member logins/day


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