Healthcare Payer Services

Payers in theory are responsible to ensure that the limited financial resources are used appropriately to create services, provide broad access to the needed healthcare services, and ensure patient safety and affordable healthcare coverage.

Over the years, healthcare systems across the globe are increasingly looking for payment models that drive value based care and respond to rapidly changing patient expectations. Cylon Technologies provides effective solutions for public, private payers and healthcare insurers by helping them improve outcomes and in managing costs by enabling customer focused care models and outcome based models.

Cylon Technologies brings with it deep domain expertise in claims management services by using processes that are in tandem with global standards. We offer a wide range of payer services and solutions that provides you the resources you need to efficiently process claims, manage wellness and in maintain privacy.

Our innovative payer solutions enable you to derive operational excellence for healthy patient experience and relationship and our services offer solutions covering –

  • Pre-Adjudication

  • Adjudication

  • Post Adjudication

  • Medicare Risk Adjustment

  • Data Management for major PPO, HMO and indemnity to government sponsored plans like Medicare, Medicaid, Workers Compensation etc.

Cylon Technologies Healthcare Payer Services and Solutions– An Overview

Cylon Technologies in recent years with its innovative solutions has moved towards value based models by following the Care Management Solutions (CMS) when it comes to adopting value based care payment protocols.

We have focused more on cost management and efficiency enhancement initiatives with the spot light on Value Based Care or VBC enablement as it is expected to shape the industry in the near future. We have digital capabilities and domain expertise through acquisitions through both organic and inorganic means.

Cylon Technologies as healthcare payer service providers are more agile and are better prepared to adapt to regulatory changes that are occurring frequently especially in healthcare regulations. We have expertise in understanding the potential impact of digitization and as such have invested heavily in healthcare insurance technology.

Some of the technology solutions and services that we offer under the umbrella of healthcare payer services include-

  • Healthcare Plan Administration and Customer Care Solutions

  • Digital Transformation Solutions

  • Care Integration Services

  • Payment Integrity Solutions

  • Care Management Solutions

  • Credit Balance Solutions

In addition, Cylon Technologies is providing a wide variety of consultative services that are designed to assist our clients in all aspects of compliance regulations. We use the impetus of change to rethink about all our operations from our customer experience to claims management. For more details about our healthcare payer services – Get in Touch.

 

Why Cylon Technologies - Achieving Greater Efficiencies

Spending for hospital care in the United States grew to a total of over $1 trillion dollars in 2017 accounting for 32% of the country’s healthcare spending. This upward trajectory of US healthcare spending is leaving payers, beneficiaries and health providers to cut or control their costs while maintaining a high level of quality.

As such Cylon Technologies offers core and ancillary business process management (BPM) and knowledge process management (KPM) support services across the payer spectrum to achieve care management that intends to reduce the unnecessary healthcare costs through a wide variety of mechanisms that includes assessment, planning, facilitation, care coordination and evaluation.