Business Process Outsourcing and Technology Solutions for Health Plans

Mature Global Delivery Model | Seasoned Health Plan BPO Professionals | Proprietary Automation Tools

At Access Healthcare, we specialize in providing comprehensive Health Plan BPO services that simplify the clinical and financial experience for patients and healthcare providers. With our intelligent back-office solutions and clinical services, we empower health plans to streamline operations, enhance patient care, and improve outcomes.


Our Healthcare Payer BPO services combine domain expertise, process transformation, and advanced technologies like Conversational AI, RPA, and Analytics to redefine excellence. Leading healthcare organizations trust us to drive innovation, revenue growth, and profitability.

We understand the importance of impacting every healthcare moment along the customer journey, no matter the size or significance. Our tailored solutions leverage next-gen technologies to transform operations. Conversational AI enhances customer interactions, while RPA automates repetitive tasks, improving productivity and accuracy. Analytics provides data-driven insights for informed decision-making. Our approach drives top-line revenues and bottom-line profitability, making us a trusted partner in the healthcare industry.

Partner with Access Healthcare to revolutionize your Health Plan Business processes.

Let us reshape your operations, driving innovation, improving patient outcomes, and unlocking growth opportunities. Trust us to be your strategic partner in delivering operational excellence, process improvement, and sustainable success in the ever-evolving healthcare landscape.


Why Choose Access Healthcare?

  • Intelligent Back Office: Our innovative back-office solutions optimize administrative processes, claims processing, premium billing and collections, configuration services, eligibility, and enrollment services, appeals and grievances, and customer services. We simplify complex processes to ensure efficiency and accuracy.

  • Payer BPO Financial Improvement Processes: Our expertise in financial improvement processes includes coordination of benefits, eligibility verification, overpayment identification and recovery, fraud, waste, and abuse management, and achieving 5-star ratings for Medicare Advantage plans through the Medicare Star Quality Rating System.

  • Payer BPO Care Management Processes: We strengthen care management processes through utilization management solutions, telemedicine support, and integrated case management. Our focus is on enhancing patient outcomes and optimizing care delivery.


Success Stories

Discover how our Health Plan BPO services have made a tangible impact on the operations and outcomes of health plans like yours. Read success stories from our satisfied clients who have experienced cost reductions, improved efficiency, enhanced patient care, and increased member satisfaction through our tailored solutions.

“I wanted to thank you all again for the hard work and dedication you put into every process you help the Membership Operations team with. The team processed 962 profile update cases during the month of June with a QC score of 100%! Thank you.
— Membership Operations, Program Manager,Medicare Advantage Plan
I wanted to reach out after what felt like a successful training meeting with the team today. I was training the team on the end-to-end workflow for Provider Data Cases and as I was going through the SOP, the team made a couple of great suggestions to make the process more efficient. I really appreciated their feedback and want to reiterate how encouraged it is!
— Provider Operations Leader

Ready to Transform Your Health Plan Operations?

Take the first step towards optimizing your health plan operations. Get in touch with our experts today to discuss your specific requirements and explore how our Health Plan BPO services can benefit your organization. Together, we can drive efficiency, improve patient care, and achieve your desired business outcomes.