Patni Introduces Claims-as-a-Service (CaaS) for Health Insurers

Global outsourcing services company Patni (Mumbai/Cambridge, Mass.) has announced "Claims as a Service (CaaS)" for healthcare payers. The hosted solution combines Patni's ITO and BPO services with by TriZetto's (Newport Beach, Calif.) QNXT core administration platform.

CaaS supports the complete claims life cycle from intake, through adjudication, to customer service, including mailroom and fulfillment services, claims processing, enrollment and eligibility maintenance, member services, premium billing, reconciliation, provider maintenance and post payment audits, according to a Patni source. Any of these services can be selected on an a la carte basis, enabling health insurers to delivery administrative and care management functions at an affordable cost without compromising on quality, Patni pitches. CaaS pricing includes all costs of transition from the existing system and is based on the number of members serviced on a monthly basis, the Patni source states. The vendor says that a highly flexible, subscription-based structure allows insurers to support continuing growth while taking advantage of attractive price breakpoints. The vendor also argues the advantages of the solution for avoiding the risk of regulatory non-compliance associated with out-of-date systems, insufficient knowledge of current technologies and limited budgets.

"Automating manual processes will create more transparency providing the visibility needed to meet regulatory requirements and manage the performance of the business," says Ganesh Iyer, senior vice president, insurance practice, Patni. "Healthcare payers will experience faster settlements, improved reporting and more flexibility in pursuing new business opportunities while remaining compliant with emerging regulations."

Anthony O'Donnell has covered technology in the insurance industry since 2000, when he joined the editorial staff of Insurance & Technology. As an editor and reporter for I&T and the InformationWeek Financial Services of TechWeb he has written on all areas of information ... View Full Bio