PAYER CORE

Revolutionizing Payer operations with AI and Automation

Driving efficiency, innovation, and operational excellence in core systems and business processes

PAYER CORE

Modernizing core applications ecosystem and processes with digital technology

Modernize operational processes such as claims, enrollment, billing, and customer service to enhance care quality, member satisfaction, and regulatory compliance. Leverage CitiusTech’s next-generation technologies, solutions, products, and expertise to reduce Total Cost of Ownership (TCO) and improve operational efficiencies. Deploy automation, GenAI capabilities, and best-in-class 3rd party platforms to become a digital-first connected enterprise.

Advisory
or Consulting

Product
implementation

Operations
optimization

Legacy modernization and migration

Download Key Trends

features

Transforming end-to-end core operations

Seamless implementation

Implement a core administrative platform that seamlessly aligns with business functions, delivering operational benefits in cost efficiency and quality improvement.

Payer core engineering

Avail engineering services across customization, data integration, and/or integration with upstream and downstream applications.

Boost agility and productivity

Leverage our center of excellence coupled with accelerators for configuration, testing, and automation to increase speed-to-market and productivity.

Case Study

Implemented HRP to serve 600K+ members

Migrated 127+ benefit plans for a health system to HRP. Flexible workflows and rules boosted the claims auto-adjudication rate to 90% and led to a 40% reduction in time to market for new health plan launches.

Case Study

Implemented payment integrity business rule engine

Implemented Drools for agile configuration and management of business rules engine, supporting 200+ Payers. Achieved 85% faster processing and 6.5x system efficiency improvement.