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INDUSTRIES/ HEALTHCARE & LIFE SCIENCES/ HEALTH PLANS

Third-Party Solutions

Transform how you serve customers with new products and services

Take third-party administrative capabilities to the next level with proven high-performing claims platform implementation, application migration, analytics, hosting and business processes.

When you can use proven methodologies, you take third-party operational capabilities to the next level. With Third-Party Solutions by NTT DATA, you can implement new applications to gain new functionality, upgrade existing applications to improve operations, or optimize end to end functionality with confidence. Seamlessly manage enrollment, billing, tracking, pricing, reporting, member care management and provider/product data and ultimately improve the customer experience.

Take third-party administrative capabilities to the next level with proven high-performing claims platform implementation, application migration, analytics and business processes.

We can help

Lower administrative costs through proven implementation methodologies and operational best practices

Make better decisions with insights from business intelligence and analytics

Improve customer experience with member care management and other services

Our Solutions:

Implementation /Upgrade and Delivery Management

Ensure seamless system implementation and delivery management without disrupting existing operations. We offer a holistic deployment approach to system readiness with services for configuration, logistics, integration, migration, governance and go-live support. Our solution includes well-defined governance model, communication, resource and scope management strategies; standardized delivery components and regulations; deliverables tracking, project management performance reporting and RAID management.

Configuration, Conversion, Integration and Development

Drive operational efficiencies to help you achieve dramatic improvements in the performance and agility of your IT environment. We help manage, design, integrate and implement next-generation payer processing platforms, as well as analytics and operational support. We can provide system assessment and road-mapping, configuration design and data mapping, impact analysis, risk and issue management processes, business workflow and training instruction design, and comprehensive system, integration and use case testing.

Quality Assurance and Testing

Improve service quality, drive down costs and meet stringent regulatory demands. We provide multiple test disciplines and practices to integrate customer-specific test requirements using commercial/open-source tool-based automation frameworks, embedded business analysts, robust solution accelerators and flexible delivery models. We provide a full range of testing services, strategic testing consulting, proven test processes and governance models, specialty testing services and ready-to-use innovative test solutions and frameworks.

BPO and Business Process Design

Boost quality transaction speed, control costs and improve policy administration. We offer integrated business process and technology solutions to help you streamline operations, improve productivity and strengthen cash flow to stay competitive and improve member satisfaction. We can help with front, middle and back office solutions, provider data maintenance, claims and encounter processing, plan setup and maintenance, provider pricing and management, eligibility and enrollment, and more.

Data Analytics and Reporting

Gain meaningful insights from data, manage costs, lower risks. Our-advanced analytics help you proactively identify risk and member outcomes with integrated data from multiple sources to gain insights critical to your financial and health plan success. Our solution includes exhaustive reporting for financial, operational and provider analytics, payer code edits, key performance indicators monitoring, reimbursement optimization, provider contact negotiations, risk prioritization, native integration with ICD-10, reporting and analytic customization, and more.

Member Care Management

Implement Member Care Management to improve member satisfaction through wellness programs, disease management and case management. Improve member outcomes using care transition management services. Improve on existing care management services by optimizing the operational design and configuration. And provide Remote Patient Monitoring (RPM) by implementing the RPM services of member care management.

Consulting and System Tuning

Unlock efficiency, improve business performance and lower costs. We help you assess your current operation state and perform system tuning to optimize your platform so your health plan organization can run smarter, faster and perform better. We provide value-based consulting and thought leadership, operational and system assessments, comprehensive frameworks, system tuning and testing, and implementation and support services.

System Support and Configuration Management

Maximize uptime, increase efficiency and ensure environment consistency. We provide one team for end-to-end implementation, from your health plan consumer portal all the way to your back-office functions. We can help you with root cause assessment, system recommendations, application and solution optimization, and end-to-end process and technical support.

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