Digital Themes

Gain Competitive Advantage With Future-Ready, Smart Automation

Healthcare organizations are finding that generating profits is difficult in today’s regulated and competitive environment. Incremental improvements are often not sufficient to meet the requirements. While new business models and strategies are key to success, operational agility enabled by lean operations and robotics process automation is key to keeping up with changing market demands. In this, a competitive environment with demands for reduced costs and more robust SLA’s, healthcare organizations have an opportunity to team knowledge workers in Enrollment, Provider Relations, Claims, Compliance, Service and Finance with Digital Workers to perform manual intensive and error-prone activities.

Robots can operate 24 X 7 and effectively establish cases to be managed, aggregate data from disparate sources, identify how to reduce latency and call duration, and proactively push work to the next best action to meet the customer requirement. Robots are a complement to Digital Process Automation (DPA), Customer Relationship Management (CRM) and other transformational initiatives being undertaken. Virtusa’s Robotics and DPA teams have proven solutions and services throughout the Healthcare value chain.

Digital Solutions and Services

Robotic Process Automation

Bring together AI, cognitive technologies and automation to automate processes and improve efficiencies

Robotic Process Automation

Manual processes and segregated, legacy systems are usually at the center of rising operation costs for healthcare organizations. From Sales & Marketing, to Provider Network Management, to Claims and Customer Service, there are an abundance of areas that would benefit signification through the application of robotic processes.

Virtusa’s Robotic Process Automation solutions align digital workers with your knowledge workers to significantly reduce costs while improving satisfaction from providers, members and third parties. Our solutions automate mundane and repetitive tasks on a 24 X 7 basis to ensure your knowledge workers have the information needed for provider onboarding, claims adjudication, and customer service, eliminating bottlenecks and latency experienced by manual tasks. We architect process automation as an enterprise solution so that it fosters reuse and can handle data ingestion, lookups to legacy systems, document aggregation and other functions across the value chain. We do this through short-duration projects without disrupting existing systems and processes, to maximize your ROI.

Provider Lifecycle Management

A disruptive platform that modernizes all aspects of a Payer's complex provider network management capabilities

Provider Lifecycle Management

For Payers to manage their vast Provide Network effectively is not only critical but a strategic differentiation in today’s competitive environment. However, Payers today have limited provider management capabilities. They’ve stitched together legacy applications, manual processes, and error-prone point-solutions that create long provider onboarding times and causes major data quality issues.

Virtusa’s Unified Provider Lifecycle Management solution – with capabilities supporting Prospecting, Contracting, Credentialing, System Setup, and Provider Servicing – can help Payers dramatically reduce their operational costs and improve their provider satisfaction. Using emerging technologies in Robotics and AI, the PLM platform reduces a plan’s overall Provider onboarding time by 50%. All business-critical components are integrated together on an intelligent business process management platform, significantly cross team efficiencies. Our Industry leading Smart Credentialing functionality leverages Robotics to gather and validate data from Primary Sources, reducing manual efforts by >80%. The platform automates over 90% of the manual steps related to the intake and processing of hundreds of Roster files received daily/monthly from hospitals.

Customer Contact Center

A customer-centric platform that enables a superior customer experience for its members, providers, and key stakeholders

Customer Contact Center

Payers are continuing to witness an influx of digitally savvy stakeholders (members, providers, brokers), who are demanding quality services and transparency of information. Members can freely switch plans, and inquire about their coverage, enrollment and pre-existing conditions. However, Payers face several challenges in providing an exceptional and consistent customer experience due to the prevalence of inflexible legacy systems that are rigid and not integrated. Also, members expect information across multiple channels and expect it to be consistent.

Virtusa’s Contact Center Solution is a Customer-Centric Engagement Platform that provides a 360-degree customer view. Utilizing the latest emerging capabilities around chat bots and robotics, information is easily accessible to CRSs looking to serve Member, Providers, and other key stakeholders. Guided flows enable CSRs to quickly generate accurate benefit details or answer complex questions related to claims. This innovative platform helps organizations reduce average call handle times, reduce CSR training times, increase first call resolution, and improve call wrap-up times.