|
Business models in Healthcare industry are in a constant state of flux. Wipro believes that payer’s ability to succpeed in this evolving business environment is based on achieving three strategic objectives:
- Better Care Management
Focused on providing appropriate care setting for delivering patient centric care
- Excellence in Operation
Focused on improving internal quality and efficiency to meet the partner’s need
- Focus on Consumerism
Focused on driving the power of consumer to the healthcare purchasing processes and health advocacy
Wipro has, therefore, developed Centers of Competencies (CoC) to research and develop solutions and services to help payer organizations achieve these strategic objectives. These CoCs are:
- Healthcare analytics CoC focuses on decision support and business performance. The solutions and services developed by this center focus on consumerism and on increasing information transparency to achieve excellence in operation. Additional information on analytics center can be accessed using following link
- Care management CoC focuses on improving quality and delivery of care by developing solution and services in the area of:
- Transformation solution CoC focuses on developing solutions and services to increase operational excellence in the payer organization. Some of the initiatives of this CoC include:
- Legacy modernization using SOA Services and Facets Services
- Implementing Enterprise Application Services (EAS) in the organization. EAS includes CRM, ERP, SCM packaged applications among others
With more than 10 years of healthcare domain experience, Wipro has been supporting leading payer organizations in their business transformation initiatives. Wipro is, therefore, well placed to support the payer’s journey to next generation health plan by providing business value through its CoC and expertise in technology.
Some Services for the Payers and Health Plans
| Consulting Services |
Technology Solutions |
Business Process Outsourcing |
- Claims Process Transformation - for improving claims performance and reducing medical losses
- Chronic Care Management - to reduce cost of management of chronic disease care
- Pay for Performance - rolling out P4P programs to cover wide range of physician practices
- CDHP Services - HSA integrations, real-time underwriting, claims analytics
|
- Healthcare Analytics - reporting, denial management, disease analytics
- eHealth Platform - self service portals, healthcare portals
- Pended Claims Automation
- Trading Partner Management - for B2B middleware maintenance and legacy system integrations
- Compliance and Security - HIPAA and SOX compliance
|
- Claims Administration - process pended claims, input paper claims into systems and provider, member and customer call center
- Network Management - provider database maintenance, credentialing and contract management
- Medical Management - referral administration and outbound calls
|
| Packaged Applications (SAP, Ariba, i2, Siebel, Peoplesoft, JD Edwards) |
EDI Services
Web Services
EAI Services
|
BI and DW
ETL Consolidation
Healthcare Analytics |
eHealth Portals
Self service portals
Clearing House integrations |
Remote Infrastructure Mgmt.
Server Consolidation ITIL implementation |
Industry Solutions
|
