Healthcare Payer Solutions and IT services

We provide healthcare payer services to help payer organizations improve patient outcomes, serve member demands, and enable more affordable care.

Improving patient outcomes with accessible care

As the healthcare industry transitions to a member-centric, outcome-driven model with new regulatory and financial standards, there is greater demand for advanced IT services to fuel digital innovation.

With accelerated adoption of digital experiences, data interoperability, and stakeholder engagement, payers can unlock new opportunities. By fostering collaboration, sharing patient data proactively, and delivering enhanced experiences, payers are poised to strengthen member loyalty and retention.

Intellias partners with leading health plans to integrate cutting-edge digital solutions, data-driven strategies, and collaborative approaches to lower care costs, improve patient outcomes, enhance member satisfaction, and advance healthcare professional experiences.

Our offerings

Manage commercial, Medicare and Medicaid markets 

Intellias manages IT platforms for the specific needs of individual health insurance plans across commercial, Medicare and Medicaid (MMIS) domains. We do this through:

  • Data aggregation and analytics to centralize and analyze member data to predict churn and identify growth opportunities
  • Digital transformations to use market-ready digital platforms to respond to member needs effectively
  • Intelligent automation to streamline processes to enhance member transitions
Improve customer experience 

Lack of transparency, personalization and sophisticated digital capabilities have historically plagued the health industry, contributing to it having one of the lowest Net Promoter Scores. Additionally, care fragmentation and lack of real-time data exchange across health ecosystems often result in poor engagement and health outcomes for members.

Intellias healthcare payer solutions leverages automation and cutting-edge technologies to facilitate seamless collaboration and coordination for enhanced customer experiences with providers and plan benefit managers.

Maintain regulatory compliance 

Archaic legacy systems and security controls can introduce risks for health plans to remain compliant with regulatory requirements. Intellias healthcare payer consulting helps organizations implement robust data security measures and electronic recordkeeping systems that align with industry standards and privacy regulations. We also use AI-powered tools to conduct audits, analyze claims data and monitor transactions to easily identify and address any compliance issues quickly.

Increase accessibility and affordability 

Intellias offers health equity, analytics and reporting solutions to enable health insurance plans to improve accessibility and convenience for their members. Through data science and AI-driven solutions built on cloud connectivity, we optimize administration cost and clinical care.

Our tech-enabled solutions 

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Credentialing-As-a-Service

eliminates errors and increases accuracy for credentialing providers on different health plans

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Process Automation

transforms repetitive tasks for increased efficiency

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Denial Management Processing

identifies, manages, monitors, and prevents any monetary damage to an organization

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Revenue Cycle
Management (RCM) Suite

includes helping determine patient eligibility, collecting co-pays, and coding claims

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AI-enabled tools

analyze member data to create tailored benefits plans that align with individual needs, improving satisfaction and retention.

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Connectivity solutions

help payers manage provider networks efficiently, ensuring accurate information and streamlined operations.

We speak code. Our numbers speak for themselves 

3k+

experts in 17 locations around the world

23

years in the market

100+

Health and MedTech consultants

350+

successful subcontract projects

We don’t brag. Our work does it for us.

Empowering Employee Wellness with a Turnkey Healthcare Payments Platform

Employer-sponsored healthcare financing platform: From idea to MVP in 8 months, and on to the product launch

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We don’t brag. Our work does it for us.

AI-Assisted Development of a B2B Healthcare Management System

Intellias leveraged the potential of AI-powered development to speed up delivery of a cloud-based medical payment system

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We don’t brag. Our work does it for us.

Enterprise-level Platform for Risk Assessment in Healthcare

We’ve designed and implemented a highly scalable risk assessment platform that allows our client to extend their service portfolio and customer base

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We don’t brag. Our work does it for us.

Enabling Nationwide Digital
Transformation in Healthcare Services

We’ve helped the national Ministry of Health introduce full-scale digitization of healthcare sector and build a smart medical ecosystem

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We’re a reliable partner for clients, backed by strong partnerships

Our technology expertise, market insights, digital acceleration tools and solutions for digital health allow us to deliver results for the healthcare industry, building lasting trust with our clients every step of the way.

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Meet our digital health technology expert

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Dave Rowe

Executive Vice President 

Dave is a 30+ year veteran in IT consulting and product development. He specializes in delivering sustainable solutions for digital health and medical devices. His expertise spans application architecture, development and device integration, and lean optimization in surgical supply chains.

At Intellias, Dave manages high-profile projects across various industries and leads engagements for medical device technologies and digital health solutions. From strategy and design to delivery and at any point in the product lifecycle, Dave’s focus is on engineering excellence and FDA or HIPAA compliance. Dave studied Quantitative Methods and Computer Science at the University of St. Thomas and Iowa State University.

Your questions answered

  • Automating administrative tasks: AI-powered tools and cloud platforms can automate claims processing, eligibility verification, and pre-authorizations, reducing manual errors and speeding up workflows.
  • Enhancing data integration: Digital solutions break down data silos, enabling seamless sharing and analysis of health data across systems. This improves decision-making and care coordination.
  • Modernizing payment processes: Digital disbursement tools streamline member reimbursements, ensuring faster, more accurate payments and reducing frustration caused by outdated methods.
  • Personalizing member engagement: Advanced analytics and AI enable payers to tailor outreach strategies, preventive care plans, and communication, fostering stronger member relationships.
  • Supporting value-based care: Digital tools help align payment models with healthcare outcomes, incentivizing providers to focus on quality and efficiency.
  • Improving operational agility: Next-generation technologies like cloud computing and APIs allow payers to adapt quickly to changing market demands and innovate faster.
  • Personalized communication: AI and analytics tools enable payers to tailor messages and outreach strategies based on member preferences, health history, and behavior. This fosters a sense of being understood and valued.
  • Omnichannel engagement: Digital platforms allow members to interact through their preferred channels, such as mobile apps, SMS, or online portals. This flexibility improves accessibility and convenience.
  • Proactive outreach: Automated systems can send reminders for appointments, preventive care, or medication refills, helping members stay on top of their health.
  • Self-service tools: Virtual assistants and chatbots empower members to resolve common issues, such as claims inquiries or coverage details, without needing to contact customer service.
  • Real-time support: Digital solutions enable instant communication with care teams or support staff, ensuring members get timely assistance when needed.
  • Health education and resources: Interactive tools and apps can provide members with personalized health tips, wellness programs, and educational content to encourage healthier lifestyles.
  • Building trust: By delivering consistent, relevant, and secure digital experiences, payers can strengthen trust and loyalty among members.
  • Automation: Automated workflows reduce manual data entry errors and streamline processes like claims processing, provider credentialing, and member record updates.
  • Real-time analytics: AI-powered tools provide actionable insights by analyzing large datasets in real time, helping payers identify trends, gaps, and opportunities for improvement.
  • Regulatory compliance: Digital solutions ensure data management aligns with industry regulations, reducing risks associated with non-compliance.
  • Enhanced member and provider data: Integrated platforms maintain up-to-date and accurate provider directories and member records, improving operational efficiency and member satisfaction.
  • Cybersecurity: Robust digital tools protect sensitive health information through encryption, access controls, and regular monitoring.
  • Telemedicine platforms: These enable remote consultations, ensuring patients receive timely care without geographical barriers.
  • Wearable health devices: Devices like fitness trackers and smartwatches monitor vital health metrics, providing real-time feedback to patients and healthcare providers.
  • Electronic Health Records (EHRs): EHRs streamline access to patient data, allowing for better care coordination and reducing errors.
  • Predictive analytics: AI-powered tools analyze patient data to identify high-risk individuals and recommend preventive measures.
  • Mobile health applications (mHealth): Apps designed for chronic disease management, medication adherence, and patient education enhance engagement and self-care.
Contact us today

Move past the limits of legacy systems. Build your data estate with confidence in its long-term value.

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