BPO for Health Plans
NTT DATA has supported healthcare and life sciences (HCLS) clients for over 50 years. We process over 100 million claims annually, achieving 99% on time and 99+% accuracy.
We augment legacy systems with cutting-edge digital solutions, robotic automation and a comprehensive library of business rules to improve processing quality and productivity. We bring positive business impact, increase efficiency, mitigate penalties, increase rating scores, reduce administrative costs and improve member and provider experience.
Today’s health plans have expanded beyond traditional claims processing, enrollment and payment accuracy. We help you manage increases in member expectations, cost competition, regulatory compliance and and labor shortages. Learn how our new patient-centric, outcome-focused solutions help maintain profitability.
25–50%
cost reduction through implementation of automation projects
< 1 year
to realize the returns on your automation investment
24x7
service by bots enabling faster turnaround
~ 80%
reduction in cycle time compared to manual processing
Our Services
Healthcare Product Development & Setup
We support healthcare payers in developing and implementing innovative healthcare products and services to meet evolving market demands.
Member Engagement
We provide digital platforms and strategies to enhance member engagement, offering personalized, intuitive and accessible experiences to improve member satisfaction and loyalty.
Healthcare Network Management
We help healthcare payers efficiently manage their provider networks, providing optimal access to quality care while controlling costs and enhancing network performance.
Fraud & Risk Management
We offer comprehensive fraud detection and risk management solutions to healthcare payers. This helps to mitigate financial losses and safeguard against fraudulent activities.
Claims Management
We streamline and automate the claim management process for healthcare payers, improving accuracy, efficiency and compliance while reducing administrative burdens.
Risk & Compliance
We support healthcare payers in navigating complex regulatory requirements and compliance standards, providing strategic guidance and solutions for adherence and mitigating risks.
Audit Services
We provide a smarter approach to auditing with an as-a-service model that can transform quality processes and achieve compliance requirements with a tailored, scalable program.
Payment Integrity
We process payments accurately in near real time by harnessing next-generation intelligence and advanced analytics through our Medical Cost Manager (MCM).
Billing & Enrollment
We process enrollments from state, federal, and private exchanges, for accurate and efficient enrollment. We provide billing, payment collection and premium remittance processing for accurate revenue recognition and receivables management.
Our key strengths
-
Scale
Own 5,000+ bots in production, 40+ productivity-based tools, 90+ RPAaaS deployments, 4,000+ skilled team members.
-
Investment
Spent $3.6 billion in R&D annually, including cognitive intelligence and AI.
-
Presence
Dedicated robotic labs in India, Europe and the U.S.
-
Partnership
Global strategic partnerships with leading intelligent automation vendors.
-
Clients
Service 85% of the fortune 500 companies.
Give your audit model a checkup!
Ask yourself these questions to determine if an Audit as a Service model can reduce operational costs and headaches for your health plan or TPA.