Overview
As healthcare enters the AI-first and digital-only era, payers look to prioritize intelligent and value-based care (VBC), data-driven patient engagement, robust data and cyber security measures, effective risk management, optimized provider network management, and meticulous compliance to regulations
Mastek combines its strong domain and operational expertise with digital technologies to deliver innovative, AI-led and data-driven healthcare payer solutions, services, and strategies. Our high-performing teams provide end-to-end services to enable hyper-personalized member experiences, high-efficiency operations, best-of-class data practices to foster agility, cost-efficiency, and operational resilience.
Problems We Solve
Mastek partnered with an Arizona-based non-profit healthcare organization to modernize its customer service experience for the Medicare Advantage (MA) population,
Headquartered in Phoenix, Arizona, Banner Health is one of the largest nonprofit health care systems in the United States.
Building Trust
A comprehensive range of managed services
Across the healthcare payer value chain, we deliver outcome-based services to enable expanded product access, superior member experiences and operational excellence - with enhanced quality and reduced costs. Key healthcare payer services include:
Enterprise Data Platform Modernization & Integrations
Enterprise Data Platform Modernization & Integrations
Interoperability & Healthcare API Management
Interoperability & Healthcare API Management
Web Portals & Mobile Apps (Member / Provider / Broker / Employer)
Web Portals & Mobile Apps (Member / Provider / Broker / Employer)
Sales and Marketing IT
Sales and Marketing IT
Customer Service Platform
Customer Service Platform
Annual Health Plan Development and Maintenance
Annual Health Plan Development and Maintenance
Healthcare AI engagement
Healthcare AI engagement
Data Management Services
Data Management Services
Delivering Value
Delivering
Value
A versatile array of Healthcare Payer offerings and solutions
Mastek’s Healthcare Payer solutions and offerings span the gamut of care delivery, patient-centric innovation, digital transformation and data-driven excellence.
AI-Powered iConnixHealth solutions for enhanced care delivery at reduced Opex costs
- Intelligent Document Processing
- Content processing
- Decision processing automation
- Chatbots and virtual agents
- Personalized experiences
Salesforce-powered HealthCloud solutions for patient-centric Innovation
- EnrolLite solution
- Smartbroker solution
- Contact center modernization
- Provider lifecycle & network management
Future-fit digital transformation
- Legacy / App modernization
- CRM solutions
- Interoperability & healthcare API development
- Digital Front Door solutions
- Business process automation
- Quality engineering solutions
Data-driven excellence
- Enterprise data & analytics platform modernization
- Health data standardization & governance
- Master data management solutions
- Unified health data platform
- Advanced analytics and AI integration
IConniX Health: A Gen-AI powered Solution Suite for Payer
iConniX Health Solution is our comprehensive Gen AI platform for the healthcare industry which aims to revolutionize business operations for healthcare payers and providers.
From automating document-heavy processes to enhancing decision-making and improving member engagement, iConniX Health leverages cutting-edge AI, machine learning, and natural language processing to streamline workflows, reduce costs, and ensure compliance.
With our tailored healthcare payer solutions, healthcare organizations can enhance operational efficiency, improve patient care, and achieve significant cost savings while delivering personalized, data-driven healthcare outcomes.
Intelligent Document Automation
Automates data extraction from handwritten and printed documents (Single/Multi-page, Color & B&W)
- Paper Enrolments
- Paper Claims
- Fax-based Auths
- Clinical Notes
- Health Risk Assessment
- Hospital Invoices
Content Summarization
Automates customized document and web-content summarization
- Explanation of benefits
- Explanation of payments
- SBC/Evidence of coverage
- Underwriting Docs
- CMS/BCBS Mandates
- Legal Documents
- Provider Credentialing Documents
- Broker Credentialing Documents
Decision Processing Automation
Automates data-driven decision processing using ML models to predict next-base-action
- Automated Case-Routing to Nurses
- Duplicate Claims Prediction
- Fraudulent Claims Prediction
- Predict Health Risk Score
- Automated CSR Assignment
- Classify Member MDM Fallouts
Chatbots & Virtual Agents
Conversational Agents to Simplify members and providers digital experience with payers
- Member Portal-Chat (Virtual Agent & CSR)
- Provider Chat (Inquiry & Claim/Auth) Submission
- Personal Health Assistant
- Medical Policy Assistant
- Product Selection Assistant
- Benefits Buddy
NLP Based Automation and Personalization
Conversational Agents to Simplify members and providers digital experience with payers
- Call/Chat Sentiment Analysis
- Personalized PCP Recommendations
- Personalized Wellness/Buyup Recommendations
- Personalized Member Education Videos
- Personalized Care Plan Assignments