Healthplans

Business Process Outsourcing and Technology Solutions for Health Plans

First Vertex Healthcare excels in delivering extensive Health Plan BPO services designed to streamline the clinical and financial journey for patients and healthcare providers alike. Through our sophisticated back-office solutions and clinical services, we empower health plans to optimize operations, elevate patient care standards, and drive superior outcomes.

Why Choose Us

Intelligent Back Office: Our cutting-edge back-office solutions streamline administrative processes such as claims processing, premium billing and collections, configuration services, eligibility and enrollment services, appeals and grievances, and customer services. We simplify intricate procedures to ensure both efficiency and precision.

Payer BPO Financial Enhancement Processes: Our proficiency in financial enhancement processes encompasses coordination of benefits, eligibility verification, identification and recovery of overpayments, management of fraud, waste, and abuse, and achieving 5-star ratings for Medicare Advantage plans via the Medicare Star Quality Rating System.

Payer BPO Care Management Processes: We fortify care management processes through utilization management solutions, telemedicine support, and integrated case management. Our primary focus is on bolstering patient outcomes and optimizing care delivery.

FIRSTVERTEX'S PROCESS EXPERTS ARE STANDING BY!

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Catalyzing Change in Healthcare Payer BPO
UNLEASHING EFFICIENCY. ENRICHING OUTCOMES.