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Solutions Overview for Health Insurers

At LTI, we provide domain-centric consulting services for business process optimization to enhance operational efficiency. We exhibit confidence in our application development, maintenance and testing services for Policy Administration and Servicing; Claims Processing; Medical re-pricing and Regulatory Reforms; and other core processes.

Our innovative solutions for business analytics have enabled our clients in the healthcare domain to look at data differently. These solutions include fraud pattern analysis, predictive analysis and business-decision support systems. We derive remarkable value out of empirical data from claims history, social media, and other sources, including consumer behavioral pattern and lifestyle captured through Health Risk Assessments and Wellness management programs; taking one more step towards Digital Transformation.

Consumers today are technology savvy and expect responses & reminders in digitized manner. Our Health Risk Assessment platform has the capability to disseminate wellness information on mobile devices similar to the Geolytik solution, which is focused on sending alerts to consumer and provider during a pandemic outbreak or catastrophic situation.

Our client experience has not only been working with Private Insurers, but also with the Public sector on:

  • Regulatory Compliance, which includes HIPAA EDI 4010 to EDI 5010 migration
  • ICD-9 to ICD-10 migration
  • Improving CMS Five Star Ratings
  • Application Integration & Portfolio Rationalization
  • Business Process Integration using BPM Workflow
  • Building Data Warehouse to support Business Intelligence

We have strong experience with Medicaid Management Information System (MMIS) application processes, and have successfully completed MMIS application development and maintenance projects for Virginia, Alaska and Nevada within the US.

We have proven expertise in executing projects for Medicare Advantage and Medicare Supplement plans governed by Center for Medicare and Medicaid Services (CMS).

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