Co-creating Patient-centric Business Outcomes

 

WNS partners with 35+ global healthcare organizations to co-create industry-leading care management solutions underpinned by domain expertise, analytics and digital.

We work with the payer and provider communities to help navigate the challenges of an evolving, regulated, cost-intensive, and evidence- and value-based healthcare landscape. We leverage collaborative care management to improve patient well-being while reducing costs. Our depth of clinical expertise translates into robust outcomes across utilization management, medical and case management, provider management, claims intake, and adjudication and medical bill review for payers. Similarly, for providers, we drive end-to-end Revenue Cycle Management (RCM) and clinical management.

With the COVID-19 outbreak putting an enormous pressure on global healthcare systems, WNS has been helping clients to adapt to the changed situation while prioritizing patient and business outcomes. Our telemedicine solutions, underpinned by digital and analytics, are enabling companies to drive innovative, affordable and remote care.

WNS-HealthHelp, certified by HITRUST and URAC, is a utilization management partner that collaborates with health plan leaders and providers to improve care and realize sustained cost savings.

 
15+ Years of Experience

15+

Years of Experience

4000+ Healthcare Specialists

4000+

Healthcare Specialists

750+ MDs, RNs & Clinical Staff

750+

MDs, RNs & Clinical Staff

15+ Digital and Automation Solutions

15+

Digital and Automation Solutions

 

Know more about WNS-HealthHelp and our comprehensive Utilization Management solutions.

 

Case:
WNS leveraged BPR, robotic automation & workforce optimization to drive significant process & cost efficiencie..
Case:
WNS deployed bolt-on automation & robotics, consolidated operations & automated work assignment
Case:
WNS designed a new operating model & created smart CoE led by intelligent automation & digital solutions

Services


From utilization management and case management, to claims and RCM – WNS provides comprehensive healthcare solutions. Our healthcare analytics solutions are geared towards helping payers and providers leverage data to drive incisive visibility amid the Value-based Care (VBC) model gaining precedence over the Fee-for-Service (FFS) model. Our telehealth solutions harness the power of digital and analytics to enable enhanced patient care and customer interactions.
 

PayersPayers
350 Mn+ Annual Savings for Clients

USD 350 Mn+ Annual Savings for Clients

180,000+ Providers & 1 Mn+ Facilities Covered

180,000+ Providers & 1 Mn+ Facilities Covered

99.5% Provider Satisfaction Scores

99.5% Provider Satisfaction Scores

 

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.

 

Utilization Management

  • Prior authorization
  • Concurrent review
  • Post-services review
  • Appeals and grievances
  • MD review / Peer review

Case Management, Disease Management & Wellness Management

  • 24X7 nurse helpline
  • Health risk assessment
  • Patient outreach
  • Case management and disease management intake
  • Medication adherence

Customer Service

  • Member support
  • Provider education
  • Provider outreach
  • Inbound / Outbound enrollment
  • Retention and renewals

Quality Improvement

  • HEDIS and CMS Star rating
  • Quality and compliance support
  • Site certification
 

 

Value-added Services

  • Provider network analytics
  • Medical management opportunity analytics and consulting
  • Utilization management trendbenders and trendbusters
  • Underwriting support

Claims Services

  • Intake and data capture
  • Adjudication
  • Adjustments
  • Medical bill review

Injury Management for Auto Medical Liability

  • Medical bill setup
  • Medical bill review
  • Medical management and utilization review
  • Contact center

Payer Analytics

  • Marketing analytics
  • Payment integrity – overpayments and fraud analytics
  • Provider data management, network performance analytics
  • Clinical data and medical costs analytics
  • Data warehouse and business intelligence reporting
ProvidersProviders
7.7 Mn Claims Processed

7.7 Mn Claims Processed

USD 1 Bn Collections Portfolio

USD 1 Bn Collections Portfolio

USD 100K Recouped in Denials Management & USD 20K in Appeals

USD 100K Recouped in Denials Management & USD 20K in Appeals

6 Mn+ Charts in Coding & Billing

6 Mn+ Charts in Coding & Billing

 

We specialize in managing provider functions encompassing administration, revenue cycle and clinical management. Our unique blend of administrative and clinical process management focuses on bending the cost curve, and improving outcomes and profitability.

We bring a skin-in-the-game approach to reimbursement to prevent revenue leakage – through coordination of treatment plans, insurance cover and alternative insurance. We help drive a high clean claims submission ratio underpinned by streamlined billing processes, robust claims follow-up practices and analytics-led decision-making. We ensure there are no payment delays from insurers, reducing the risks of higher Days Sales Outstanding (DSO) and denials. We are compliant with International Classification of Diseases (ICD) and Common Procedural Technology (CDP) coding, and strictly adhere to all accepted medical guidelines.

 

Office Administration

  • Scheduling / On-boarding support
  • Patient demographic entry
  • Insurance eligibility verification
  • Physician credentialing
  • Chart retrieval

Utilization Management

  • Utilization review support (new admissions and continued stay)
  • Pre-authorization support / Follow-ups
  • Re-consideration and appeals
  • UM billing support

Case Management

  • Benefit review
  • Care coordination support
  • Concurrent review
  • Discharge review
  • Discharge planning support
  • Transition of care support

Medical Billing and Coding

  • Billing
  • Medical billing charge entry
  • Medical / HCC coding
  • CPT and ICD-10 coding
  • Denial analysis
 

 

Revenue Cycle functions

  • Medical claims processing
  • Accounts receivable services (including follow-up and analysis)
  • Payment posting
  • Denial management

Value-added Services

  • Physician review / Peer-to-Peer services
  • Audit / Quality assurance
  • Clinical Documentation Improvement (CDI)
  • Provider education
  • Merit-based Incentive Payment System (MIPS) / Medicare Access and CHIP Reauthorization Act (MACRA)
  • Analytics and insights
  • Compliance and accreditation support

Provider Analytics

  • Denial analytics
  • Collection analytics
  • Accounts receivable trend analytics
TelehealthTelehealth
35-40%+ Digital Containment

35-40%+ Digital Containment

25-30% Increase in Customer Adoption Rates

25-30% Increase in Customer Adoption Rates

15-20% Improvement in Patient Experience

15-20% Improvement in Patient Experience

30-40% Cost Optimization

30-40% Cost Optimization

 

WNS has a long-standing experience in delivering telehealth-related services for both payers and providers. With the accelerated mainstreaming of digital healthcare due to factors such as rising costs and the COVID-19 pandemic, WNS is leveraging next-gen technologies to drive rapid telehealth outcomes for payers, providers and patients. We drive an integrated experience through our end-to-end solutions led by Artificial Intelligence (AI) and cognitive automation / chatbot, Mobile Health (mHealth), analytics and self-service.

 

Patient Education

  • Calls / E-mail / Text
  • Social media engagement
  • Online health resources
  • Live chat, chatbot & self-serve portal
  • mHealth

Initial Appointment Setup

  • Virtual visit
  • New user setup

Case-based Reasoning

  • Patient movement and remote admission
  • Training
  • Store-and-forward
  • Case management

Recurring Events

  • Alerts and monitoring
  • E-record maintenance
  • Incident escalation
  • Predictive analytics

Care Management

  • Nursing triage
  • Patient portal support services
  • Patient care coordination
  • Patient access management
  • Disease and wellness management

The WNS Advantage

Domain Expertise & Global Footprint

 13 Global Delivery Locations
 Domain-led Automation & Analytics

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 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

 ~110 MDs
 Tie-up with 12 Universities

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 a much higher 54 due to cutting-edge technological capabilities.

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