End-to-end Integrated
Medicare
Advantage Platform
Encompassing Medicare, Medicaid & MediGap
lines of business
MedAdvantage360
Experience the power of Wipro’s innovative Healthcare BPaaS platform that revolutionizes Health Plan operations. Combining the cutting-edge technology with a dedicated back-office staff, we automate CMS compliance requirements and optimize day-to-day operations, enhancing efficiency and effectiveness in core administrations. With streamlined excellence, your team can focus on delivering exceptional healthcare services to your members.
Wipro's BPaaS (Business Process as a Service) platform encompasses a range of services and capabilities that cater to the needs of diverse healthcare plans, such as Medicare Advantage Plans, Part D Sponsors, Cost Plans, Duals, Special Needs Plans, Medical Savings Account (MSA), Medicaid and MediGap lines of business.
HITRUST Certified.
An Integrated Medicare BPaaS Platform
Partner to 100+ Health Plans
Submitting 5 Million+ Monthly Transactions to CMS
Health Plans
Duals
Lives
Comprehensive BPaaS platform
Managing Multiple Lines of Business
Medicare Plans
MA, MAPD, MSA, PDP, EGWP, SNP, CSNP, DSNP, DUAL, Standalone Part D & Cost Plans
Medicaid Plans
Medicaid Advantage Plus (MAP)Medicaid Plans, Long Term Care Plans - MLTC & PACE
Medicare Supplement
MediGap / MedSup Plans coverage for coinsurance & deductibles
Transform
Core
Administration
Cutting-edge modular platform connecting integrated journey of a Health Plan
Drive
Efficiency
& Growth
New plan entering into market or existing Health Plan expanding business organically or by acquisition
Stay ahead with
Regulatory
Compliance
HITRUST Certified Application with SSAE compliance and hosted in Tier-3 Data centers
Medicare BPaaS Modular Platform
Streamline Health Plan’s journey
eEnroll360
Enrollment, Commission, HRA
Member Eligibility & Enrollment, Agent Commission Management & HRA
Read MoreMember360
Member Management
A Comprehensive Member Management System with multi-channel onboarding
Read MoreRevenue360
Revenue
Reconciliation
Accurate and timely reconciliation of Medicare enrollment and payments
Read MoreAG360
Appeals
& Grievances
End-to-end Appeals and Grievances System for management of Members and Providers
Read MoreEDPS-GT360
Encounter Data Processing & HCC
A Comprehensive Encounter data processing, submission and Risk Adjustment System
Read MoreConnect360
API, Data Transfer & Data Integration
Data exchange layer for interoperability, secure data transfer & data insights
Read MoreRisk360
HCC Risk analytics solution
A Comprehensive assessment of HCC Risk Trends & opportunity to drive financial outcome
Read MoreProvider360
Provider network Management system
Integrated Provider network solution including Provider Management and Credentialing
Read MoreCare360
Integrated Care Management solution
Integrated Care Management solution designed to achieve value-based outcomes
Read MoreAnalytics360
BI, Reports &
Dashboards
Integrated Business intelligence module with custom reporting
Read MoreClaims360
Claims Processing & Adjudication
A complete end-to-end solution for claims processing and benefits administration
Read MorePortals
Member and Provider portals
A secure self-service portal that provides access to claims and eligibility information
Read MoreEventless AEP
Unparalleled success in AEP Management through streamlined processes, improved SLAs and increased efficiency
Our Partners
CASE STUDY
End-to-end BPaaS solution
for a leading Provider
Sponsored Health Plan
Read More
Modernization of a leading BCBS Health Plan
Wipro implemented end-to-end BPaaS platform with Enrollment, Membership, Agent Commissions &
Encounters.
Read More>
Leading Medicare Advantage Start-up Plan Implementation
Wipro helped achieve growth objectives and addressed the pressing
business needs for Medicare Advantage Health Plan.
Read More>
Optimize Medicare member touchpoints to enhance engagement and maintain active involvement throughout the year
Wipro’s Medicare BPaaS platform consists of a set of integrated turnkey modules that enhance core operational efficiency of a Health Plan and achieve consistent cost controls.
The increased focus towards Member engagement is driving Health Plans to identify various touch points and optimize systems to effectively manage the member experience.