Working together to enhance quality of care while containing costs
EXL Health collaborates with you to help transform pharmacy benefit management by combining healthcare domain expertise, analytics capabilities, and digital assets.
We work with you to improve the pharmacy claims review processes to uncover discrepancies, save millions of dollars on a monthly basis, and improve network communication and compliance.
Our collaborative approach helps you contain costs, enable capacity growth, and address quality care gaps.
We empower your PBM leadership with insights enabling you to maximize operational efficiencies, improve medication adherence, and ensure appropriate medication utilization.
EXL Health’s predictive analytics solutions, clinical quality and utilization management services, workflow technology, and prescription claim auditing capabilities help you improve pharmacy management. We work with you to enhance pharmacy operations, enable digital transformation, and provide powerful population health insights that enable you to achieve market growth and expansion.
Pharmacy Utilization Management
Create efficiencies and accuracies that drive cost containment and quality outcomes.
- Proactively manage pharmacy spend
- Deliver services to impact efficiency
- Proactively manage waste
- Execute authorizations via flexible engagement model
Pharmacy Quality and Care Management
End-to-end care management services to improve patient care and support total cost of care reduction and delivery on contractual commitments.
- Identify and manage quality gaps in drug, drug-disease, and drug-age interactions and alerts
- Define and measure improvement targets
- Improve quality measures, including medication adherence, high-risk medication utilization, and inappropriate drug use
Payment Integrity for Prescription Claims
Control costs associated with incorrectly billed or overpaid pharmacy claims, focusing on prevention, avoidance and recovery.
- Effectively conduct contract, payment policy and fraud, waste, and abuse reviews
- Identify instances of overpayment
- Increase pharmacy compliance
Data & Analytics
We create the data management foundation to support advanced analytics, that help you gain insight to drive the best action.
- Contain costs
- Manage pharmacy performance
- Enhance member medication compliance
- Improve fraud, waste and abuse detection
- Reduce pharmacy abrasion
EXL Health delivers intelligence to shape strategies that transform your business.
Human ingenuity is the foundation of everything we do with you to drive success.
3 of the top 5
PBMs partner with us
Gartner Peer Insights Customers’ Choice for Data and Analytics Service Providers, 2020*
KLAS Top Ranking, Risk Adjustment & Analytics, 2020
*The GARTNER PEER INSIGHTS CUSTOMERS’ CHOICE badge is a trademark and service mark of Gartner, Inc. and/or its affiliates and is used herein with permission. All rights reserved. Gartner Peer Insights Customers’ Choice constitute the subjective opinions of individual end-user reviews, ratings, and data applied against a documented methodology; they neither represent the views of, nor constitute an endorsement by, Gartner or its affiliates. Gartner, Gartner Peer Insights ‘Voice of the Customer’: Data and Analytics Service Providers, 22 September 2020, Peers