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Lizzy Velasco - Client services delivery - Manila
outcomes. Easy, Right?

Healthcare management companies face a formidable mandate: Build high-performing health management programs that improve quality of care and patient outcomes, keep costs under control and increase consumer and provider engagement.

What we do

Accenture Intelligent Healthcare Operations helps clients deliver on all counts by combining a cloud-based analytics platform with exceptional talent. We help payers, providers and government agencies drive breakthrough growth, increase customer engagement, improve health outcomes and reduce cost.

Claim Services

Claim edits, configuration testing

Claim suspends/pends adjudication

Adjustments, rework and correspondence

Population Health

Health risk assessments

Program enrollment

Health outreach (e.g. post-discharge calls)

Utilization Management

Prior authorization intake and clinical review

Concurrent clinical review

Post-service clinical claim review and appeals support

Pharmacy Benefits Management

Benefits management and communication fulfillment

Membership Services

Case installation and member enrolment

Contract development and benefits configuration

Premium billing, accounts receivable and reconciliation

Provider Services

Data maintenance

Credentialing support

Claim and provider service support

Care Value

Member and provider outreach

Medical records retrieval and review

why work with us

Results Health BPS has delivered:


Helped a client to save nearly $140 million in total medical costs by using Accenture Advanced Health Analytics Platform

Automation helped to strategically process claims, limiting late and inaccurate payments and avoid more than $15 million in penalties

Reduced costs by $30 million per year, a 33% reduction, by scaling 1,000+ non-clinical and licensed nurses in the Philippines, India and US

"Sometimes businesses suffer from an operational illness. As diagnosticians, we see what’s wrong and know how to fix it. When we are in charge of millions of transactions or access points; we’re really at the heart of operations, so every second counts."

Theresa Gaffney
Health Business Process Services Lead - Accenture Operations

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