Innova Solutions > Healthcare Services > Payers > Reduced Operational Complexity

The client is the single largest financial and administrative healthcare network in the United States, reaching approximately 750,000 physicians, 105,000 dentists, 60,000 pharmacies, 5,000 hospitals, 600 vendors, 450 laboratories, and 1,200 government and commercial payers. The client has developed this network of payers and providers over 30 years in the industry, connecting virtually all private and government payers, claim to submit providers and pharmacies in a hybrid cloud-based, user-centric, and secure infrastructure environment.

Customer Need

The myriad of reimbursement and cost sharing models made the understanding of “what is” and “what is not” covered maddeningly frustrating for most healthcare consumers.

Most healthcare billing systems are oriented around the payer and provider interaction, leaving consumers confused with non-recognizable treatment codes, multiple statements and confusing coverage information.


Solutions Provided

As part of the solution, we enabled payments directly from within the context of the payer’s consumer claim viewing applications (i.e. a member portal or mobile app).

Simplified patient understanding of their financial obligation, as well as, the convenience of making quick payments within that same experience.

Benefits / Results

Streamlined payment process and reduced overall costs

Improved digital engagements and increased member loyalty

Reduced operational complexity and improved posting accuracy

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