Healthcare Informatics is a high-growth sector with vast opportunities and significant competitive pressures. Healthcare payers and providers are striving to keep up with an ever-changing technology and regulatory landscape, all the while looking for ways to better handle the interactions among physicians, hospitals and patients to improve the quality of treatments.

With rising healthcare costs, increased government legislation, rapidly aging population and an increasing demand for providing higher quality customer care, healthcare providers are in critical need for technology innovations. There is an increasing need to streamline operations, monitor resourcing activities, and utilize tools to analyze and improve operational efficiency. In recent years, information sharing and data collaboration have dramatically improved the delivery of health services, but it has also brought additional challenges for ensuring privacy of patient data and modernizing legacy infrastructure to enable integration between multiple systems. A quarter of the healthcare expenditure is currently spent on administrative functions, which is making it a business necessity for the healthcare industry to reinvent itself for better accuracy and efficiency. Adhering to stringent and constantly evolving safety and regulatory requirements is adding further complexity to the process. With the compliance date set for October 1, 2013, the ICD-10 migration has emerged as a huge challenge for the US healthcare industry, which has significant implication for payers, providers, pharmacies, lab and intermediaries if they don’t comply with the new standards.

In today’s competitive healthcare industry, healthcare payers are facing similar challenges to improve efficiency, reduce cost, introduce new products rapidly and comply with the constantly evolving regulatory requirements. Efficient claims processing is an area that needs a major overhaul for most payers, as M&A and inorganic growth have resulted in inefficient standalone systems and a variety of workflows. Legacy claims processing systems are not flexible enough to support new concepts such as real-time claims adjudication and CDHP plans. Incorrect usage of billing codes and duplicate services are resulting in inaccurate reimbursements and increased human intervention. But the size, age and primacy of source claims processing systems is making modernization efforts risky, time-consuming and costly. In recent years, as the industry has increasingly embraced the concept of wellness management as an effective tool for cost savings through proactive intervention, the payers are in need for state-of-the-art products and processes to implement wellness management solutions across a wide range of platforms and devices accessible to their customers.

Diginuvo understands the challenges facing the healthcare industry. With our domain expertise and access to global talent pool, we can deliver cost effective solutions that address these issues and create sustainable competitive advantage for our clients.