Payer Claims and Policy Administration

Reduce your administration costs with advanced technology

Rising costs and the advent of healthcare reform have made healthcare administration more complex and costly than ever.

Stay ahead of these challenges by outsourcing your claims and policy administration to Dell. With our expertise in cloud-based administration platforms, workflow expertise and knowledge management tools, you can streamline your processes, reduce costs, process claims faster and differentiate yourself from your competitors.

Our healthcare payer services include:
  • Claims entry and indexing 
  • Claims adjudication, including pricing, eligibility and coverage verification, provider verification, diagnosis, and treatment reconciliation through Current Procedural Terminology (CPT) and diagnosis codes 
  • Membership services, including beneficiary information, additions and changes 
  • Eligibility and enrollment
  • Provider maintenance 
  • Other Carrier Liability (Coordination of Benefits [COB], Workers Compensation and Subrogation), provider relations, and fraud detection and prevention
  • Inbound customer care for members, providers and agents
  • Analytics across financial, Healthcare Effectiveness Data and Information Set (HEDIS) compliance, underwriting, and disease and case management
Drawing upon our extensive experience with hospitals, physicians and government organizations, you can expect continuous improvement through our proven quality improvement programs and a higher return on your technology transformation investment.

Dell and ikaSystems form a strategic alliance

By combining Dell’s breadth of healthcare business process outsourcing (BPO) and technology services with ikaSystems’ cloud-based, collaborative technology platform, you’ll be able to better manage daily operations, reduce administrative costs and meet regulatory requirements with minimal up-front investment.

Working with government agencies and health insurance exchanges

States working to create their own insurance exchanges can benefit from our advanced technology solutions and the valuable insights and lessons learned from the groundbreaking efforts in Massachusetts. With our robust, user-friendly web portal application, you can quickly and efficiently manage your exchange’s enrollment and customer education needs. To learn more about our health insurance exchange offering, please click here.

Benefits of Payer Claims and Policy Administration include:

  • What if you had access to a global team of healthcare payer professionals?
  • What if you could improve processing accuracy and performance visibility?
  • What if you could reduce your total cost of ownership through cloud-based platform solutions?
  • What if you could reduce healthcare fraud and improve compliance?
Accelerate speed to market and focus core competencies

Today’s cost demands on healthcare plan organizations are palpable. You have to work smarter by reducing the cost of front- middle- and back-office processes, while at the same time, make the best use of your staff members by putting their time and resources toward crucial areas such as claims management, care management or member and provider relations.

Dell Business Process Outsourcing can help. A leader in healthcare plans-focused services, we process more than 96 million claims annually. We handle more than 11 million call center inquiries, and $3.6 billion in premium revenues managed annually. And we help you get more out of your plan’s strategy.
Talk to Dell About Business Process Outsourcing Services.
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