EXL

Vendor Overview

Description of Services: EXL Health is a digital transformation partner, leveraging a partnership ecosystem to bring the best-of-breed solutions to Payers, Providers and PBM’s. Powered by data, cloud, analytics, AI/ML, and domain expertise, EXL Health’s digital solutions improve business outcomes, help deliver great customer service, reduce cost, and strengthen quality of care. A key differentiator at EXL Health is our ability to apply Smart Operations that emphasizes creating and optimizing a Human + Digital next generation workforce. We have created Centers of Excellence to train and enable our employees to deliver next generation solutions.

Our key digital differentiators are as follows:
1. Healthcare centric solutions, that reduce healthcare cost and improve efficiencies, outcomes and bottom line profitability through accelerated deployment.
2. Modular AI solutions that easily integrate with current and legacy systems for quick ROI.
3. Combine deep domain expertise, data/analytics, & cutting-edge technology for an integrated approach.
4. Nimble approach, in order to adapt and adopt quickly, to ensure industry-leading outcomes.
5. Best in class Health Plan solutions impacting many areas and processes such as:
Clinical Services:
• Clinical and administrative business processes
• Utilization management
• Care management
• Population health analytics
• Robotic process automation
Pharmacy:
• Patient centered analytics
• Value-based outcomes, real world evidence
• Pharmacy and medical cost management
Data and Analytics:
• Payer, Provider, Life Sciences, Retail solutions and technology products
• Analytical models and digital technology
• Data assets, data scale and expertise
• Risk Adjustment
Payment Services:
• Payment Integrity and Payment Business services
• Pre/Post Pay Clinical auditing expertise- DRG, Clinical Validation, Itemized Bill review, Home Health, DME, Short Stay, SNF, High-Cost Drugs, Hospital Bill Audit, Outpatient
• Platforms and data modeling expertise
• Workflow digitalization
• Revenue Cycle Management
• Subrogation/COB
• Data Mining
• CX

Primary Service: Automation, Workflow and IT Services
Secondary Service: Claims

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320 Park Avenue, 29th Floor
New York, NY 10022
212-277-7100
https://www.exlservice.com

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