Healthcare Solutions

Healthcare Management

Traditional healthcare practices have become modern and digitalized. An abundance of options and ease of availability have allowed consumers to pay for quality and not quantity. This has compelled providers to come up with cost-effective business models. Be it payers or providers, both the segments are facing a crisis. With more and more people joining healthcare plans, Payers are increasingly burdened by huge medical insurance claim volumes. On the other hand, Providers are being pressurized to offer high-quality services at reasonable rates.

The need of the hour is to create an interface that delivers your services to the consumers (Providers) and allows easy reimbursements of the incurred health care costs (Payers). Both the segments are actively working towards deploying delivery systems that are more robust. An ideal solution to this crisis would be the one that yields improved revenue cycles and a happier member base.

Can healthcare really be high quality, if the patient-physician interaction is hurried, disrespectful, cold, callous, or uncaring?

JAMES LI

Customized Healthcare Solutions

FOR PAYERS

Product Development & Business Acquisition (PDBA)

We help the payers by planning and developing new services for their customers. We analyze the current market and utilize the insights to draft new services like new healthcare insurance plans. In addition to this, we scout through different channels to acquire new customers. At the same time, we ensure that the existing customers continue to get the benefits as promised. We also assess new policies and underwriting for the associated risks. Some of our services include:

  • Plan Development
  • Channel management
  • Risk assessment
  • Underwriting
Claims Management

Managing insurance claims is becoming a hectic job given the volume of claims that pour in. An accurate and timely claims settlement is essential for customer satisfaction. To achieve this, we provide services like claims investigation, discrepancy and fraud detection, faulty billing reporting, subrogation, and recovery, etc. Some of our services include:

  • Initial claims processing
  • Investigation and review
  • Disbursements
  • Fraud management
  • Claims litigation & recovery
Member Management

Member management plays a pivotal in any business development plan. Our member management services begin with enrolling members in the health plans. We also manage member grievances and track the problems encountered by members in the past to provide a concrete solution. We are also technically sound to record and store member data and access it across multiple channels at low costs. Some of our services include:

  • Enrollment & renewals
  • Handling of endorsements
  • Managing records
  • Billing & Collections
Provider Management

It is important for the payers to segment out their members based on their providers, membership, and engagement. The payers also need to be ready for the provider profiles too. We deploy advanced data mining and analytical tools to manage entire data. We store it in a read-to-use format too. Some of our services include:

  • Network management
  • Provider credentialing
  • Contract management
  • Records management

FOR PROVIDERS

Patient Enrollment & Strategic Planning

Customer acquisition is a crucial service for all the hospital establishments. We analyze the provider network and customer needs to strategize and transform existing services models. Our team ensures that the services reach out to the patients through effective channels. An empathetic approach and seamless deployments add more value to your business. Some of our services include:

  • Enrollment
  • Patient base analysis
Patient Care

We provide an array of services to providers for efficient patient care. We adhere to the stringent regulatory guidelines that govern the healthcare sector and undertake medical transcription, imaging, and device monitoring. Our team, with an in-depth knowledge of the medical protocols and provider care systems, offers round the clock patient care services for improving customer relations. Some of our services include:

  • Medical transcription
  • Medical imaging
  • Device monitoring
Revenue Cycle Management

Revenue generation is a vital business operation. We digitalize medical billing and other back end processes to transform the entire revenue cycle. Right from documentation to claim submissions; we are capable of handling every back end queue to improve business productivity and claim turn-around times. Some our services include:

  • Medical billing
  • Medical Coding
  • Collection
  • Claim filing

The Healthy Approach

We have a competent team that is well trained to handle aggressive volumes of incoming claims and queries. With a proficient approach, secured management, and lower operational costs, Epicenter has helped big insurers to get for themselves a distinguished market standing. Our adept IT functions and a stringent compliance with regulatory norms allow providers to be more efficient, accurate and cost-effective.

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