Health & life sciences

Human Ingenuity is our catalyst

We believe in the power of Human Ingenuity – our innate ability to work together with our clients to improve outcomes, optimize revenue, and maximize profitability. By combining our customer-centric approach, our domain expertise, data and analytics, and proprietary technologies, we make healthcare transformation happen.

We do this through our value-added capacity, technology and analytic-enabled solutions, and insight and advisory services.

Who we serve

Together, we work with clients across the healthcare ecosystem to meet their current and dynamic business challenges.

Health solutions

Clinical services

Together, let’s drive quality outcomes and impact medical spend

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Data & analytics services

Together, let’s drive innovation and informed decision-making

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Digital services

Digital innovations that transform how healthcare is delivered, managed and paid.

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Life sciences

Together, let’s get the right treatment to the right patient at the right time

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Payment services

Ensure payment claim accuracy and reduce fraud, waste, and abuse

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Pharmacy services

Together, let’s enable the power of pharmacy.

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Provider finance & accounting operations

Partnering with healthcare providers to drive growth and profitability.

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Risk adjustment & quality

Industry-leading and KLAS recognized risk adjustment and quality expertise

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Transformation starts with inspiration. See the latest ideas from some of our leaders.

Case study

Cognitive AI solution transforms contact center for lead...

Case study

Cognitive AI solution transforms contact center for leading healthcare organization

Cognitive AI solution transforms contact center for leading healthcare organization The challenge A leading healthcare organization was looking to improve its provider-focused contact center operations for precertification processing. After an in-depth assessment of their operations, which included the types of calls, call volumes, average handle time, and provider satisfaction, the organization identified several areas of challenge, including

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Case study

Cognitive AI solution transforms contact center for lead...

Case study

Cognitive AI solution transforms contact center for leading healthcare organization The challenge A leading healthcare organization was looking to improve its provider-focused contact center operations for precertification processing. After an in-depth assessment of their operations, which included the types of calls, call volumes, average handle time, and provider satisfaction, the organization identified several areas of challenge, including

View Case study

Infographic

Digital Healthcare Operations: Case management

Infographic

Digital Healthcare Operations: Case management

Reduce administrative tasks so case managers can focus on providing care In today’s healthcare environment, clinical and non-clinical teams can spend more than one-third of their time on administrative tasks as part of the case management process. This work often requires accessing multiple systems and an excessive amount of manual tasks. Applying additional non-clinical or clinical staffing, and digital technology solutions, such as AI and automated co

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Infographic

Digital Healthcare Operations: Case management

Infographic

Reduce administrative tasks so case managers can focus on providing care In today’s healthcare environment, clinical and non-clinical teams can spend more than one-third of their time on administrative tasks as part of the case management process. This work often requires accessing multiple systems and an excessive amount of manual tasks. Applying additional non-clinical or clinical staffing, and digital technology solutions, such as AI and automated co

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Solution sheet

EXL Health Pre-Payment Auditing Services

Solution sheet

EXL Health Pre-Payment Auditing Services

Payment integrity programs are moving beyond a post-payment approach to identify billing and payment anomalies before claims are paid. By shifting payment integrity audit activities earlier in the claims-adjudication process, payers achieve improved efficiencies, greater insights, and higher savings through improper payments prevention, without upsetting the claim adjudication lifecycle. Leverage digital technologies to deliver speed and accuracy Thr

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Solution sheet

EXL Health Pre-Payment Auditing Services

Solution sheet

Payment integrity programs are moving beyond a post-payment approach to identify billing and payment anomalies before claims are paid. By shifting payment integrity audit activities earlier in the claims-adjudication process, payers achieve improved efficiencies, greater insights, and higher savings through improper payments prevention, without upsetting the claim adjudication lifecycle. Leverage digital technologies to deliver speed and accuracy Thr

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Case study

Innovation during pandemic results in successful virtual...

Case study

Innovation during pandemic results in successful virtual pharmacy audit program

Challenge Pharmacies play a critical role in keeping communities healthy. When the COVID-19 pandemic hit, pharmacies needed to take special measures to protect their customers and staff, including limits on who was allowed onsite. These adaptations impacted pharmacy audits, which are essential to cost containment, overpayment identification, and compliance. In 2020, our client, a large national pharmacy benefit manager (PBM), came to us looking for a

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Case study

Innovation during pandemic results in successful virtual...

Case study

Challenge Pharmacies play a critical role in keeping communities healthy. When the COVID-19 pandemic hit, pharmacies needed to take special measures to protect their customers and staff, including limits on who was allowed onsite. These adaptations impacted pharmacy audits, which are essential to cost containment, overpayment identification, and compliance. In 2020, our client, a large national pharmacy benefit manager (PBM), came to us looking for a

View Case study

Why EXL Health

Applying our expertise in AI, analytics and cloud, we make sense of your health-related data, enabling you to improve outcomes, optimize revenue, and maximize profitability across the care continuum. Our digital dexterity and Human Ingenuity are the catalysts to solve complex healthcare problems.

We accelerate your ability to transform how healthcare is delivered, managed and paid. We amplify how quickly, efficiently and affordably you deliver quality care—enhancing your performance with nimble, scalable solutions.

Together, we will do this.

6,000+
Healthcare professionals including 2,100+ clinical resources

300+
Coding and claims experts

260+ million
Unique life touch points

550+
Data scientists

1,000+
Employer groups represented

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8 of the top 15

life sciences companies

6 of the top 10

US payers

2 of the top 3