Key Differentiators
A member’s ability to take care of their health depends on more than just having health coverage; it's about having the right coverage and staying covered through changes in life, accessing affordable care, simplified claims processes and real-time personalised support. From enrolling in the right plan to managing prescriptions and claims, health plans have the power to proactively guide members, reduce complexity, and improve health outcomes. Keeping members engaged and being responsive throughout their healthcare journey is critical, not only to ensure they receive the right care at the right time but also to improve retention, reduce costs, and drive better long-term outcomes.
Health plans need more than just software; they need a partner that supports scaling, staying compliant, and allows them to focus on delivering an excellent member experience. Whether it is a plug-and-play integration or a full-service approach, we provide the technology and expertise while empowering health plans to focus on what matters most: delivering high-quality, accessible, and affordable healthcare.
Automation that scales, services that deliver.
Keeping members engaged and supported through their healthcare journey
Key Differentiators
How it Works
For health plans operating in Medicare, Medicaid, ACA exchanges, and private markets, managing the member journey while staying compliant comes at a cost. As regulations and member expectations continuously shift, administrative inefficiencies can lead to higher costs, increased risk, and missed member engagement. Health plans need a solution that can adapt to their unique operational demands and a technology partner that understands that one size does not fit all. PayerAI is an interoperable solution that combines the power of technology, operations and platform to deliver a modular service.
Payer AI is a powerful suite of AI-driven solutions that operate on a three-prong model comprising the payer-in-a-box component that provides the flexibility to integrate modular solutions into existing ecosystems. Thereby enhancing functions such as eligibility verification, retention, or back-office administration across Medicare, Medicaid, ACA, and commercial plans. Cognitive Claims Lifecycle Management to streamline claims with smart adjudication and actionable insights; and Agentic AI Customer Services to transform support with real-time translation, voice neutralization, and AI-powered agent assist.
Together, these solutions cut costs, drive efficiency, and deliver seamless, personalized member experiences.
PayerAI doesn’t just automate, it thinks intelligently, learns continuously, and connects authentically. From understanding member sentiment in real-time to predicting needs before they are voiced, this platform creates seamless, proactive, and deeply human experiences across every channel. and PayerAI is powered through Wipro Intelligence, our unified AI suite, to help payers modernize, automate, and operate with greater precision. By embedding intelligence where it creates real business advantage, we combine scalable AI platforms, domain‑rich solutions, and co‑innovation through the Wipro Innovation Network—our global ecosystem of labs, partners, start‑ups, academia, and deep‑tech talent. This integration enhances how we serve our clients, unlocking AI, automation, and ecosystem partnerships that drive faster decisions, smarter operations, and measurable impact. The result: clarity over complexity, delivered through consulting‑led, AI‑powered solutions that boost efficiency, ensure compliance, and deliver real‑world outcomes at scale.
What We Do
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