The Challenge

Rising healthcare costs, new technologies and the shift toward value-based reimbursement models are disrupting traditional business processes for payers. With costs for chronic care growing and the Affordable Care Act adding millions of newly insured members, payers must manage funding gaps and find ways to improve care for members while lowering costs and navigating the changing regulatory environment. Payers need help bolstering their technology capabilities to build the next-generation business models that will bring value to members.

emids Capabilities

With our healthcare IT expertise and experience working with more than 100 healthcare organizations, we can help you modernize systems, uncover inefficiencies and develop tech-focused strategies to tackle industry challenges. We understand the impact of regulatory reform and the processes necessary to achieve the highest productivity in your business. Our services are technology agnostic and can help you:

  • Identify and address gaps in business processes to improve efficiency, accuracy, cost savings and customer service turnaround.
  • Configure the requirements and regulations necessary for administrative systems and claims and legacy applications to run efficiently.
  • Develop systems to ensure payment integrity and portals to connect with members.

emids Experience

We have brought business value to payers by:

  • Optimizing a claims system for a Fortune 500 health insurance company, identifying $236 million in overpayments and reducing claim analysis cycle time by 25 percent.
  • Modernized a marketplace system for a leading managed care firm, building in 5,400 exchange contracts in five months.

Learn how we can help you solve your biggest healthcare IT challenges.
Contact us at info@emids.com or (615) 332-7701.