PAYER AND PROVIDER EXPERIENCE

Enrollment as a Service

The enrollment experience journey of new members is imperative to the success and adoption of health plans. The intelligent enrollment process needs to consider the member experience in its entirety and eliminate siloed operations, complex workflows, and data interpretation errors. These process inefficiencies lead to a cost burden for health benefit providers.

Mphasis through its Front2Back transformation approach and next-gen solution help redefine member experiences. In addition, our AI-enabled health benefits enrollment-as-a-service - EnrollEnrich io aims to overcome challenges due to multiple enrollment engines, inputs, and customer bases enrollment processes and enrich member enrollment journey.

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Prior Authorization as a Service

A predictive and responsive insurance authorization process is vital for availing critical healthcare services without delay by eliminating the repetitive manual work.

Mphasis leads with an experience-first foundation and is focused on transforming member, provider, and payer interactions through innovative and cognitive solutions. PriorAuth.io is an intelligent automation solution from the Mphasis Healthcare Innovation portfolio, which provides end-to-end automation and real-time processing of Patient Intake/Authorization forms from providers, standardization and completion of the authorization request, workflow customization, and request fulfillment.

Provider Credentialing

Provider credentialing is a critical process for both providers and patients, as it authenticates providers' services for patients to ensure credibility and patient safety. This highly complex, data-intensive, and time-consuming process requires real-time verification and updating of provider credentials to the payer network quickly and efficiently.

Mphasis AI & design-led Provider Experience solutions empower the healthcare ecosystem to enhance provider experience by simplifying the tracking and reporting of the critical credentialing process. Our automation solution helps streamline and standardize the provider credentialing process by integrating intelligent workflows that verify information against managed data.

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Provider Engagement/ Member Engagement

Today, the healthcare industry's success lies in transforming healthcare member experiences to build trust and loyalty throughout their health journey. Digital and emerging technologies like portals, mobile app, bots, live chat, wearable integration are reshaping how patients and health care professionals interact with each other, how the data is monitored and shared with providers, payers, and members and how health outcomes are delivered in value-based care.

Mphasis next-gen technologies powered by Artificial Intelligence and Machine learning help drive data-driven decision-making and process optimization to improve the patient experience while enhancing health care service delivery. Our SuperApp is an intelligent and integrated app designed for payers and members to get a single view and quickly gain access to critical pieces of information across the care continuum - life and wellness apps, device monitoring, claims payment, and status.

Digital Front Door

Patients expect integrated experience across major touchpoints, providing them end-to-end care, ease-of-use, and quick access to healthcare. Digital Front Door solutions create an ecosystem of services that aim to help patients, providers, and agents with a seamless experience that improves patient outcomes and reduces the cost of care.

Mphasis Digital Front Door and Digital Health Solution simplify user care across the care continuum and builds on the existing clinical datasets and applications to provide a single gateway for the patient medical records. Our digital solutions on Easy billing, integration with revenue cycle management systems, Patient access portal, Rx/medicine refills, Conversation bots, and Easy navigations help optimize healthcare workflows while reducing costs.

FHIR - Fast Healthcare Interoperability Resources

Mphasis, has created an Interoperability exchange system for connecting various entities in the healthcare and life sciences sector with different transaction standards to make systems/products/applications/instruments interoperable. This interoperability exchange complies with different transaction formats like HL7, HIPAA X12, FHIR and can create an FHIR based lake on the cloud (AWS, Google, Microsoft) using the Hyperscalers FHIR services or on Hybrid environments using a combination of HAPI FHIR servers and Hyperscale services. This provides a plug n play FHIR data interface for all systems to enable reimagined patient, practitioner, provider & payer experiences.