Payer Solutions

Future-proof your Core Administrative Processing System: Strategic insights for healthcare payers

For healthcare payers, the core administrative processing system (CAPS) is the nucleus of operations, customer experience interactions, billing, revenue realization and workflow management.

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Pharmacy audits uncovered: Are pharmacy benefit managers doing enough?

Pharmacy Benefit Managers (PBMs) play a crucial role in overseeing prescription drug spending, ensuring that claims are accurate and preventing fraud, waste and abuse.

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over 1 year ago

Recovering millions for a nationwide payer

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Modernizing outbound communication - print and digital processes for business efficiency

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about 3 years ago

Closing gaps in care and enhancing member engagement with proactive outreach

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Case study: 24+ years of partnership with a major health plan leads to billions in recoveries

Recover more overpayments and improve the bottom line through our long-standing alliance with providers.

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NelsonHall NEAT Summary Report for Conduent: 2024 Healthcare Payer Operations Transformation

NelsonHall ranks Conduent as a Leader in Healthcare Payer Operations Transformation

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over 1 year ago

Three strategic guideposts for health plans in the fast-paced digital age: Part 3 – Payment Integrity Solutions

Now, in part three, we set our sights on the guidepost that illuminates the path forward to business sustainability: payment integrity.

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Credit Balance Solutions: Recover more overpayments through our long-standing alliance with providers

As a neutral third party with a nation-wide provider network, we partner with provider and hospital system billing offices on your behalf to validate credit balances and optimize recovery.

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Everest Group Healthcare Payer Operations PEAK Matrix Assessment 2023 - Focus on Conduent

This year Conduent is positioned as a Leader for its ability to support the healthcare payer value chain with innovative product development and end-to-end solutions.

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about 2 years ago

BPaaS Infograpic - Four areas pivotal to health plan operations success

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NelsonHall NEAT Summary Report: 2023 Healthcare Payer Operational Transformation

Conduent is designated as a Leader in the Overall market segment in 2023’s NEAT report for Healthcare Payer Operational Transformation.

Three key strategies for small to mid-sized healthcare payers in the Medicare Advantage market

The MA market has been dominated by a handful of large healthcare plans, but as demand for these plans grows, more and more regional plans and startups are seeing opportunities to enter the market.

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Saving a regional health plan $5.4M+ per year in claims processing costs

Partnering with us, this healthcare plan achieved big savings and a nearly five-fold increase in its processing capabilities to handle more than 3.3M claims annually.

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