What we do

We get it. Health plans increasingly demand that service providers address top-of-mind objectives.

To meet today's challenges, EXL offers a wide variety of solutions.

Pre- & Post-Utilization Services

Precertification

Predetermination

Clinical claim review

Steerage

DRG

Claims prep and consult

Coding review

Appeal management

Preventive Services & Utilization Management

Lifestyle coaching

Maternity counseling

Disease management

Prospective, concurrent, and retrospective reviews

Appeal and denial management

Peer review support

Low-touch Case Management

Identification and stratification of potential participants

Enrollment and scheduling for assessments

Risk assessments and surveys

UR coordination for authorizations including inpatient, outpatient, DME, specialty, pharmacy

Network steerage

Quality & Compliance

Special investigation unit

End-to-end HEDIS solution

Interventions for Star Rating improvements

Intelligence

Digital Intelligence is the foundation of everything we do, and inspires our ideas and research. 

Real results

For businesses that aren't satisfied by good enough, or profitable enough, we use Digital Intelligence to deliver real results.

Why exl
Digital transformation strengthened by deep domain knowledge

EXL’s clinical teams, analytics experts, and care management technologists, backed by unparalleled knowledge of the changing healthcare landscape, deliver solutions that address the industry’s most critical challenges. We partner with clients to achieve optimized outcomes, both financial and clinical.

These efforts have received recognition from healthcare industry analysts; most recently we were awarded a full URAC Health Utilization Management (HUM) accreditation until March 2022. We were also named a “Leader” in the “IDC MarketScape: U.S. Healthcare Clinical and Financial Analytic BPO Services 2017 Vendor Assessment,” and we were positioned in the “Winner’s Circle” in the “HfS Blueprint Report: Healthcare Business Operations Services 2017.”

5 of the top 10
US health plans partner with us
1 in 6 American
lives touched by CareRadius®
1850+ nurses
delivering care management outcomes

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