Payer Systems and Applications

Healthcare payers are increasingly adopting new technology to improve health outcome, sustain business growth, and remain competitive. In addition, they are facing challenges in determining the effectiveness of operations, monitoring of resourcing activities and overall financial health.

Healthcare ISVs are continuously innovating to deliver products which meet the above needs of payers segment. With years of experience, working dedicatedly on US healthcare domain and having understood the challenges in the payer segment, we have developed tools and frameworks to help you develop high quality efficient systems.

Our expertise, along with, the skilled resources have enabled us to build different payer systems such as point-of-enrollment system, and claims administration system.

Services

Leveraging our years of experience working with payers and healthcare ISVs we offer different services including:

• Product engineering
  Product engineering services for different healthcare payer products such as claim administration system, point-of-enrollment system, member management system, and provider contracting system
• QA and testing
  End-to-end testing and QA services for different healthcare payer products such as claim administration system, point-of-enrollment system, member management system, and provider contracting system
• Maintenance and support
  Maintenance and support services for different payer products such as claim administration system, point-of-enrollment system, member management system, and provider contracting system

Solutions

• Mobility
  emids provides services and tools for integrating payers products to mobile devices
• Interoperability
  emids' end-to-end interoperability framework ensures internal and external interoperability capabilities of the enterprise systems
• HIPAA 5010 transition and business testing
  HIPAA 4010 to 5010 transition services for payer system leveraging our frameworks, tools and test scripts to speed up implementation 5010 compliance initiatives
• ICD 10 transition
  Using our prebuilt frameworks, ICD 10 impact analysis tools and test scripts repository we provide impact assessment, remediation planning and assessment, and ICD 10 testing services to ensure smooth transaction

Benefits

• Prebuilt frameworks, tools and test scripts to speed up the planning and implementation 5010 and ICD 10 compliance initiatives
• Reusable test scripts and repository of use cases on payer process for efficient development of payer systems
• Access to pool of resources with payer system expertise ensures effective product development

Case studies

• Development and QA of PoE application for a leading payer
• Implementation of  auto adjudication tool for a leading payer
• Technology migration of claim administration product for a leading payer
• Developed Revenue Cycle Management (RCM) modules for a leading EMR/EHR vendor
• Revenue cycle management services for a leading EHR vendor

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