Health Care

DfineTech partners with 35+ global healthcare organizations to co-create industry-leading care management solutions underpinned by domain expertise, analytics and digital.

We work with the payer and provider communities to help navigate the challenges of an evolving, regulated, cost-intensive, and evidence- and value-based healthcare landscape. We leverage collaborative care management to improve patient well-being while reducing costs. Our depth of clinical expertise translates into robust outcomes across utilization management, medical and case management, provider management, claims intake, and adjudication and medical bill review for payers. Similarly, for providers, we drive end-to-end Revenue Cycle Management (RCM) and clinical management.

With the COVID-19 outbreak putting an enormous pressure on global healthcare systems, DfineTech has been helping clients to adapt to the changed situation while prioritizing patient and business outcomes. Our telemedicine solutions, underpinned by digital and analytics, are enabling companies to drive innovative, affordable and remote care.

DfineTech-HealthHelp, certified by HITRUST and URAC, is a utilization management partner that collaborates with health plan leaders and providers to improve care and realize sustained cost savings.

Payers

DfineTech collaborates with payers to drive a host of outcomes, including enhanced patient care, reduced costs, improved Medical Loss Ratio (MLR)-related profitability and optimized provider collaboration, to name a few. We develop evidence-based guidelines across multiple specialties such as radiology, cardiology, oncology, pain, orthopedics and sleep care.

Providers

We specialize in managing provider functions encompassing administration, revenue cycle and clinical management. Our unique blend of administrative and clinical process management focuses on bending the cost curve, and improving outcomes and profitability.

We bring a skin-in-the-game approach to reimbursement to prevent revenue leakage – through coordination of treatment plans, insurance cover and alternative insurance. We help drive a high clean claims submission ratio underpinned by streamlined billing processes, robust claims follow-up practices and analytics-led decision-making. We ensure there are no payment delays from insurers, reducing the risks of higher Days Sales Outstanding (DSO) and denials. We are compliant with International Classification of Diseases (ICD) and Common Procedural Technology (CDP) coding, and strictly adhere to all accepted medical guidelines.

Telehealth

DfineTech has a long-standing experience in delivering telehealth-related services for both payers and providers. With the accelerated mainstreaming of digital healthcare due to factors such as rising costs and the COVID-19 pandemic, DfineTech is leveraging next-gen technologies to drive rapid telehealth outcomes for payers, providers and patients. We drive an integrated experience through our end-to-end solutions led by Artificial Intelligence (AI) and cognitive automation / chatbot, Mobile Health (mHealth), analytics and self-service.