Healthcare Services

Healthcare customers are becoming truly multi-channel and multi-dimensional. They want to interact with their health insurance providers seamlessly and real-time over phone, text, email, web or social media. Healthcare payers of the future need to evolve to provide better services and gain competitive advantage.

Capgemini can lead your business process transformation across the full healthcare value chain, from claims management to commissions and compensation processing, and from distribution services to product performance monitoring.

Our healthcare capabilities span the entire spectrum ranging from IT solutions and traditional business process outsourcing to full service third party administration services and advanced healthcare consulting services.

We implement and support major vendor packages, such as ALIP, Ingenium, Claims Component, Dragon, PolicyStar, Claims WorkStation, FAB, TIA, TriZetto Facets, COMPASS, GroupFacts, ClaimFacts, and Amarta.

Our clients include commercial payers like Medicare Advantage, Medicare Prescription Drug and Medicare Supplement payers; accountable care organisations, providers, retail and wholesale pharmacies, and clearing houses.

Want to know more about breakthrough technologies that will have maximum impact on insurance transformation? Explore our latest thinking and world-class research at www.worldinsurancereport.com

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Want to talk to our experts? Write to us at healthcare@capgemini.com

A5STAR Services & Visualization Tool

A5STAR Services & Visualization Tool

Our service offering and proprietary visualization tool for advanced analytics help you Assess, Analyze, Aim, Act and Achieve

Automated Medical Claims Processing

Automated Medical Claims Processing

Reduce operating and administrative costs with an automated medical claims processing solution that provides flexibility and rapid deployment for changes while complying with the Health Insurance Portability and Accountability Act.

Full Service Administration for Health Insurance

Full Service Administration for Health Insurance

Capgemini helps carriers move from a fixed to variable cost model by leveraging a robust platform and licenses to do business across all 50 states.

HIPAA 5010 and ICD-10 Conversion

HIPAA 5010 and ICD-10 Conversion

From the initial assessment phase through implementation and beyond, Capgemini can help with your HIPAA 5010 and ICD-10 conversion to ensure a smooth transition.

Medicare Advantage

Medicare Advantage

With a deep understanding of HMO, FFS, PPO and POS plans, Capgemini helps payers reduce costs, improve business processes and gain efficiencies.

Medicare Supplement Insurance

Medicare Supplement Insurance

We process over six million Medicare Supplement claims a year through our integrated suite of applications that combines leading third-party software and Capgemini’s proprietary applications to deliver end-to-end administration, automation, continuous optimization, and increased visibility for decision making.

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