Drive Efficient Payer Operations
As the healthcare landscape continues to evolve, we help payers navigate industry challenges and deliver high-quality, cost-effective care to patients.
We offer tailored human-centric payer solutions that deliver optimized payer operations, enhanced patient experiences, and regulatory compliance.
- Improved Decision-Making. Enhance decision-making with contextual insights.
- Reduced Turnaround Time. Minimize your team’s workload and shorten turnaround time by deploying omnichannel outreach.
- Reduced Operational Costs. We help drive reduction of operational costs by as much as 30% — whether you’re a large payer, a regional health plan, or a national PPO.
Measurable Healthcare Outcomes
Reduced outreach effort
Faster turnaround time
Fewer outreach attempts
Lower operational costs
Our Solutions
Delivering seamless operations, reduced costs, and exceptional patient experiences.
Business Processes
- Claims Administration: We enable end-to-end claims processing operations, including data entry, validation, adjudication, and payment processing for healthcare payers, ensuring accurate and timely processing of insurance claims while reducing administrative burdens.
- Enrollment, Eligibility, and Benefits: We help healthcare payers streamline member enrollment and eligibility verification processes, handling tasks such as data entry, documentation review, and member communication. This ensures timely access to healthcare services for members and accurate maintenance of member records.
- Customer Service and Member Support: We help healthcare payers deliver superior customer experiences and ensure member satisfaction through best-in-class customer service and member support services, including call center operations, member inquiries, and issue resolution.
- Population Health Management: We partner with healthcare organizations to enable robust population health management strategies, including preventive care initiatives, health screenings, chronic disease management programs, and community outreach efforts to address social determinants of health.
- Provider Management: Sutherland’s provider management solutions deliver consistently accurate directories, accelerate updates, consolidate outreach efforts, and meet “No Surprises Act” requirements.
- Credentialing and SmartCred™: Our SmartCred platform accelerates credentialing with automation to enhance experiences, improve quality, and increase consistency. It also powers omnichannel outreach to reduce provider friction and improve turnaround time.
Experience-Led Digital Transformation
We help healthcare organizations leverage digital technologies to streamline operations, enhance customer experiences, and improve overall efficiency. Our domain experts provide strategic guidance and drive implementation in areas such as digital transformation, healthcare technology adoption, operational efficiency, revenue cycle management, regulatory compliance, healthcare policy analysis, and more.
Data and AI
Data and Analytics
We help healthcare organizations solve complex business problems and derive insights from data to support decision-making, identify cost-saving opportunities, and improve business outcomes.
AI
We help organizations unlock the transformative potential of AI to transform various aspects of healthcare delivery, including diagnosis, treatment planning, personalized medicine, disease management, and administrative processes.
Technology Services
- Application Services
- Application Migration and Modernization
- Quality Engineering and Digital Assurance
- Product Engineering
- Enterprise Solutions
- Intelligent Process Automation
- Cloud Enablement and Migration
- Infrastructure Services
- Cyber Security
Regulatory Compliance and Risk Management
We help healthcare payers navigate complex healthcare regulations and ensure compliance with industry standards by assisting them in developing risk management strategies, conducting audits, and addressing compliance gaps.
BPaaS
Sutherland’s Business Process as a Service (BPaaS) offering combines the best of our deep domain expertise and ecosystem of digital engineering capabilities to create an end-to-end solution tailored to your business DNA. Our Healthcare BPaaS services are transforming the way healthcare organizations manage their operational workflows and encompass a range of functions, including claims processing, revenue cycle management, billing, appointment scheduling, and more.
Accelerate Transformation with End-to-End Digital Engineering Solutions
Define
Strategy Blueprint
Revamp business with profound industry and technological expertise.
Design
Reimagined Experiences
Create superior experiences using a multi-lens world view.
Develop
Tailored Solutions
Build disruptive custom tech and data platforms to unlock insights.
Deploy
Market-Leading Tech
Swiftly deploy and harness bespoke technology solutions.
Drive
Innovation at Scale
Manage and optimize enterprise systems and apps at scale.
High-Impact Digital Engineering Use Cases
Healthcare Platforms
Powering innovation for your digital transformation journey
Manage large volumes of healthcare data and deliver actionable insights
SmartHealthConnect and SmartHealthAnalyticsOmnichannel outreach through our SmartCred platform reduces provider friction and cuts turnaround time
SmartCred™Roster automation, inventory management, data cleansing, and validation
Patient survey management platform for healthcare providers
Cross-Functional Platforms
Automate processes and create valuable capacity for strategic work
Robility<strong><strong><strong><strong><strong><strong>®</strong></strong></strong></strong></strong></strong>Intelligent supply chain visibility platform
eSeal<strong><strong><strong><strong><strong><strong>®</strong></strong></strong></strong></strong></strong>Smarter knowledge management for superior customer experience – powered by AI
HelpTree.AIAI-powered intelligent document processing platform
Extract.AISupercharge your automation journey with end-to-end test automation
CloudTestrAI-powered omnichannel customer experience platform
Sutherland Connect<strong><strong><strong>®</strong></strong></strong>Sophisticated AI-powered chat and voice automation for self-service interactions
Conversational AIUnlocking Digital Performance
Improved Efficiency
Automate processes such as claims processing, billing, and payments to reduce manual work, speed up transactions, and minimize errors.
Cost Savings
Streamline operations and reduce administrative overhead to reduce costs to enable competitive pricing and optimize resource allocation.
Enhanced Member Experience
Improve customer service and drive higher member satisfaction and retention through quicker claims processing and personalized member communications.
Regulatory Compliance
Ensure adherence to laws and regulatory requirements such as HIPAA.
