Healthcare Payer

Efficiencies, outcomes, and growth drive business imperatives for payers. A complex and changing healthcare environment challenges those goals. Managing high-risk and rising-risk patients' care continuum, automation, and reducing rates of human errors are keys to reigning in expenses. Vee Technologies has been delivering extraordinary outcomes for payers. With the move toward value-based payment structures, payers are focusing on developing new business models, enhancing IT capabilities, building a better care coordination infrastructure, and lowering administrative costs.

We offer core and ancillary business process management (BPM) and knowledge process management (KPM) support services across the payer spectrum: claims management, member management, provider network data management, contract management, finance and accounting.

Our IT services and consulting speed time to market, lower ownership costs and increase ownership values for our payer clients. Our analytics solutions have helped our payer clients translate data into knowledge to get meaningful insight for actionable business decisions. We deploy data mining, statistics, modeling, machine learning, and artificial intelligence to make predictions about likely business outcomes to help payer clients sustain their competitive advantages.

Our payer talent team includes BPM, KPM, and subject matter experts, former employees of payer organizations as well as IT professionals who work on the leading-edge technologies, data scientists, and analytics gurus. We align closely with the business needs, goals, culture, and core values of our clients.

Claims Management
Our claims BPM and KPM services lead to significant reductions in cost and TAT (turnaround time) through integrated process redesign and technology innovations. Our paper to EDI conversion, combined with repricing and rule-based auto adjudication support service, helps clients further cut down on cost.
Medical Coding Services
The accuracy of medical coding directly impacts the revenue of healthcare providers. The ever changing healthcare landscape and regulations makes it imperative to stay up to date with the latest in coding guidelines.
Member Management
Our member enrollment services reduce the administrative burden and cost to support member enrollment processes. Our eligibility and benefits configuration, backed by our knowledge-based platform, addresses the industry problem of inaccurate benefits configuration.
Provider Network Data Management
Our provider network data management process mitigates the problem of increased labor costs due to enhanced complexity of provider payment arrangement and provider network contracts. Efficient provider credentialing service avoids incorrect contract rates in claims.
Case Studies
Risk Score Optimization through CDI
Scope: A major university-based health system wanted a thorough review of their documentation to see if it was supporting the level of care they are providing to the risk adjusted patient population.
Provider Data Management - Process Innovation and Technology Result in Cost Savings
The Challenge: A cost intensive update process required checking data on all provider information update forms, rather than the ones which were actually changed (typically only 40%).