Payers
Let’s partner your way to drive your business forward
EXL Health works with you to stay ahead of the value-based curve to drive transformation across cost, quality, and member/provider experience. Our deep domain expertise and extensive capabilities across the healthcare ecosystem uniquely position us to deliver heightened value to your business and exceed the needs of your providers, members and key stakeholders.
Together, let’s find a better way
Our extensive data assets, advanced analytics methodologies, and digital capabilities, coupled with our domain expertise, help you improve quality of care and patient outcomes, enhance member engagement, and manage the cost of care.
Our innovation includes proprietary platforms, including Risk Adjustment, care management, end-to-end HEDIS, and STARS and HEDIS optimization strategies.
Our data management expertise helps you make sense of and manage your data, enabling you to turn your data into an asset that delivers insights for better decision making.
What we do
EXL Health’s technology and analytics-enabled solutions and services deliver innovation, automation, and performance excellence to impact payment accuracies, cost management, quality outcomes, and appropriate utilization – all key to value-based performance success.
Drive better outcomes and informed decision-making through total cost of care analytics, population health solutions, and member engagement.
Identify and prevent or recover from payment errors associated with improper claims payments.
Strengthen operational effectiveness, improve medication utilization and adherence, and enhance clinical and financial outcomes.
Industry-leading and KLAS recognized risk adjustment and quality expertise
Latest insights
Transformation starts with inspiration. See the
latest ideas from some of our leaders.
White paper
Digital transformation: Health plans poised to reduce op...
White paper
Digital transformation: Health plans poised to reduce operational costs by 50% over the next 5 years
Analysis from EXL experts shows that investing in a data led strategy and embracing the widespread deployment of digital technology including GenAI will result in major reductions in waste via dramatically lowering administration costs, significantly reducing benefit expenses, and improving member satisfaction.
Learn how 8 change management strategies can make digital transformation happen
Health insurance companies manage a variety of operational ac
Analysis from EXL experts shows that investing in a data led strategy and embracing the widespread deployment of digital technology including GenAI will result in major reductions in waste via dramatically lowering administration costs, significantly reducing benefit expenses, and improving member satisfaction.
Learn how 8 change management strategies can make digital transformation happen
Health insurance companies manage a variety of operational ac
White paper
The patient experience: Leveraging data for personalized...
White paper
The patient experience: Leveraging data for personalized care
In a recent study from Forrester, 90% of respondents acknowledged that their business’s overall success relies on consistent, accurate, and fast access to data and insights. 1
In the 21st century, healthcare is at one of its most transformative phases. As technology advances at an unprecedented rate, it intertwines with medicine, redefining patient experiences and expectations. Today’s patients are digital natives, well-informed and more connected than
In a recent study from Forrester, 90% of respondents acknowledged that their business’s overall success relies on consistent, accurate, and fast access to data and insights. 1
In the 21st century, healthcare is at one of its most transformative phases. As technology advances at an unprecedented rate, it intertwines with medicine, redefining patient experiences and expectations. Today’s patients are digital natives, well-informed and more connected than
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
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
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
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
Infographic
Digital Healthcare Operations: Digital utilization manag...
Infographic
Digital Healthcare Operations: Digital utilization management
Payers rely on advanced technology to assess requested care
An effective utilization management program helps payers manage the cost of benefits while ensuring the most effective, efficient, and highest quality of care and outcomes for its members. Without automation and the right people in the right place, the review process can be cumbersome and time-consuming, prone to mistakes and leading to dissatisfaction from both patients and healthcare provider
Payers rely on advanced technology to assess requested care
An effective utilization management program helps payers manage the cost of benefits while ensuring the most effective, efficient, and highest quality of care and outcomes for its members. Without automation and the right people in the right place, the review process can be cumbersome and time-consuming, prone to mistakes and leading to dissatisfaction from both patients and healthcare provider
White paper
Intelligent operations in today’s health care landscape:...
White paper
Intelligent operations in today’s health care landscape: Why adding digital is the key to success
Facing growing pressure to drive down costs, increase quality outcomes, and improve member and provider satisfaction rates, today’s health care organizations are looking to digitize operations to streamline business processes. By doing so, stakeholders hope they’ll exponentially increase efficiencies and make it possible to deliver next-level care.
To survive and even thrive in this challenging business climate, health care organizations must take advan
Facing growing pressure to drive down costs, increase quality outcomes, and improve member and provider satisfaction rates, today’s health care organizations are looking to digitize operations to streamline business processes. By doing so, stakeholders hope they’ll exponentially increase efficiencies and make it possible to deliver next-level care.
To survive and even thrive in this challenging business climate, health care organizations must take advan
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