Healthcare Solutions

Our suite of Health Insurance products for Government and Commercial insurance providers come with complete end-to-end integration. These include:

  • HPS: The next generation Healthcare Administration platform by HP, built upon Service Oriented Architecture, recognizes the need for ease of use while utilizing a leveraged set of processing services to support both Commercial and Government Healthcare payers.
  • MetaVance: A fully integrated, HIPAA-ready administrative application that enables single or multiple insurers, employer groups and managed care organizations to administer HMO, PPO, indemnity and other hybrid managed care programs.
  • Atlantes: HP's Atlantes Integrated Care Management System provides healthcare organizations with a comprehensive set of tools to plan and manage cost-effective care for members. The system is highly flexible, enabling case managers to create multiple levels of care and track an unlimited number of diagnoses and procedures for each of these levels.
  • Healthcare Portal: A stand-alone commercial software portal application provides self-service capabilities for healthcare members, providers, employer groups and brokers.
  • Healthcare IT Services for Several Blue Cross Blue Shield Plans and Commercial Health Plans: We provide our expertise to BCBS and Commercial Healthcare service operators in domains such as:
    • Membership Management
    • Benefit Administration
    • Provider Networks and Contracts
    • Claims Adjudication
    • Prior Authorization
    • E-Prescription
    • Portal - Member, Provider, Employers, Brokers
    • Managed Care
    • Premium Billing and Financials
    • EDI
    • Sales Management
    • Care Management
    • Customer Support
  • Javelina: Javelina is an open source web-based platform from Eldorado, specifically developed to manage today's claims adjudication and administration imperatives. This solution is flexible and scalable to meet future healthcare-management challenges. Learn more
  • HEALTHpac: HEALTHpac is a flexible and powerful healthcare claims administration platform from Eldorado, known for its low-cost ownership and operation as well as proven customer service. Learn more
  • MHygea: Our Hospital Management Information System, MHygea, provides a 360 degree view of hospital operations and workflows and enables you to manage the hospital as an enterprise.Learn more
  • ICD 10 - iNTELLi 10 Suite: iNTELLi Suite is a comprehensive solution that helps healthcare payers and providers assess the impact of the change on their business and create strategic roadmap for compliance either through complete remediation or through tactical approach. iNTELLi suite comprises of best-in-class tools and frameworks for impact assessment, crosswalk management, ICD testing and payment neutrality analysis.Learn more
  • Healthcare Analytics - Preventing Readmissions: Hospitalizations account for nearly one-third of the total $2 trillion spent on health care in the United States. In majority of cases, hospitalization is necessary and appropriate; however, a substantial fraction of all hospitalizations occur when patients return to the hospital soon after their previous stay. These rehospitalizations are costly, potentially harmful, and often avoidable. Mphasis with its deep healthcare knowledge has developed an analytics framework to reduce readmissions and thus help organizations avoid cost and penalties.
  • ACO IT Framework: Accountable Care Organizations are going to play a very crucial role in the US Healthcare. To achieve the core objectives of improving care delivery and reducing cost, ACO's need a solid IT foundation supported by advance analytics. Mphasis ACO framework comprises of IT tools and services that lays the foundation for achieving the ACO's business objectives.
  • Health Insurance Exchange: HIX presents payers a new channel to sell their health insurance products. To address this new market, payers will need to customize their business processes and IT systems. Mphasis has been helping payers in addressing their integration and portal needs and thus making them ready for business through health exchanges.
  • Facets Integration with Datawarehouse: Mphasis has extensive understanding and experience of integrating Trizetto's Facets solution with existing Datawarehouse in payer environments.
  • Facets Configuration and Testing Services: Mphasis provides facets configuration and testing services through its highly experienced team of facets analyst. The team has extensive healthcare domain knowledge and Facets product expertise in the areas of benefit configuration, provider agreements, provider networks, claim adjudication, business rules configuration and member services.
  • Healthcare EDI Practice: Mphasis has several years of experience in delivering EDI services to the healthcare industry. We provide EDI migration, new EDI platform setup, EDI environment configuration, EDI testing, L1/L2/L3 support, etc. Mphasis EDI expertise spans across all the leading EDI tools and platforms. We are helping healthcare payers with all the EDI compliances such as 5010, ICD-10, Administrative Simplifications, Health Information Exchanges, etc