Payers Payers
Healthcare

Payer

On the Digital Path to Enhanced Care & Maximized Value

WNS collaborates with payers to drive a host of outcomes, including enhanced patient care, reduced costs, improved Medical Loss Ratio (MLR)-related profitability and optimized provider collaboration, to name a few. We develop evidence-based guidelines across multiple specialties such as radiology, cardiology, oncology, pain, orthopedics and sleep care.

 

$350 Mn

Annual Savings for Clients

180,000+

Providers

1 Mn+

Facilities Covered

98%

Provider Satisfaction Scores

 

Solutions Led by Digital and Analytics

Medical Bill Review (MBR)

Medical Bill Review (MBR)

Driving best-in-class MBR services across front-end activities, bill and code review, and medical management to improve accuracy, process efficiency, regulatory compliance and customer experience while reducing costs.

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Provider Lifecyle Management

Provider Lifecyle Management

Delivering end-to-end provider lifecycle management solutions built on knowledge and experience, leading to a near 100% provider satisfaction score in most cases.

Claims Management

Claims Management

Comprehensive solutions with a transformative approach, streamlining claims functions, including digitization of claims setup, rules engine enhancement for higher auto adjudication, and use of Artificial Intelligence (AI) / Machine Learning (ML) for an efficient appeals process.

 
Clinical Programs

Clinical Programs

Driving targeted clinical programs focused on delivering shared savings to health plans, by improving the health risk profile of the covered population.

  • Utilization Management: Highly efficient utilization management solutions underpinned by evidence-based models that are backed by technology and advanced analytics
  • Care and Wellness Management: Digitally driven data hub and advanced analytics suite with a unified view via apps / portal to design and run care and wellness management programs
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Member Services and Enrollment

Member Services and Enrollment

Empowering members to make informed decisions, reducing the burden on plans and improving plan satisfaction.

Digital Customer Experience

Digital Customer Experience (CX)

Leveraging WNS EXPIRIUS, a Digitally Integrated CX Service Model, to simplify processes, deliver superior business outcomes and build trust with members and providers.

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Telehealth

Telehealth

Helping payers use a proven Telehealth model to enable virtual care and drive engagement with members using personalized care and support models.

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Business Transformation

Business Transformation

Driving transformation with value-based care, clinical programs and claims decision support – using technology and domain to optimize cost and improve quality along with superior member and provider experience.

 

WNS Advantage

Domain Expertise and Global Footprint: WNS brings 15+ years of specialized experience to support more than 35 leading companies from 13 global delivery locations. Our expansive footprint and strategic delivery centers allow us to deliver to our clients the benefit of reduced medical and administrative costs. We continue to invest in domain-driven automation and analytics to improve business outcomes. Our global talent pool comprises medical doctors, registered nurses, pharmacists, certified medical coders, data scientists, data modelers, data visualization specialists, transformation experts, F&A and reporting associates, and programmers. Apart from the HITRUST and URAC accreditations, we are also Quality Improvement Organizations (QIQ) certified – one of the few companies in our peer group to have achieved this certification.

Depth of Clinical Knowledge: Over the years, we have successfully augmented our clinical knowledge. We develop evidence-based clinical guidelines across multiple specialties such as radiology, cardiology, oncology, pain, spine and orthopedic, sleep care and specialty drugs. We have a dynamic clinical leadership team and staff, with ~110 medical doctors. We are also associated with 12 of the most renowned medical universities. We have managed to develop deep payer and provider relationships – we work with ~180K providers and our provider satisfaction scores are higher than the industry benchmarks. While the average healthcare industry Net Promoter Score (NPS) stands at 20, WNS scores much higher at 54, due to cutting-edge technological capabilities.