Healthcare
Healthcare reform is creating an environment of unprecedented uncertainty and complexity. Healthcare payers and providers will need to find new business models to support operational and clinical quality, reimbursement and stakeholder management.
IBM offers a comprehensive set of services and solutions for managing critical front- and back-office processes for healthcare payers. Our offerings include:
- Case and policy administration: Member enrollment, Profile management
- Claims management: Claims collection, Claims adjudication, Claims settlement and correspondence and reporting
- Benefits administration and billing: Billings and collections
- Provider relations: Contract management and credentialing
Your enterprise can leverage BPO services to respond to changes in healthcare plan administration. We execute process models that can help your organization control costs and focus on growth while improving operational efficiencies and optimizing existing resources. We can also help you address the demand for and complexity of affordable healthcare plan options and manage compliance with increasingly burdensome regulation.
Our deep health plan process knowledge and global delivery capabilities can help your organization take advantage of global sourcing opportunities to reduce workforce costs and boost your competitive advantage.
Animas uses IBM advanced analytics to speed revenue cycles
An IBM order-to-cash solution improves claims processing by 65 percent and speeds payment posting.
Rethinking Value Delivery in Health Plan Operations
Read how the changes in healthcare are driving increased need for operational excellence.