Working together to enhance quality of care while containing costs

How does EXL Health innovate for you?

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.

What we do

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

Learn more

WHY EXL HEALTH

3 of the top 5
PBMs partner with us

2,100+
Global Clinicians

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

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