Seamless Membership Experience
for Diverse Market
Addressing distinct market needs
under single umbrella
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Medicare Advantage & Medicaid
Experience the power of Wipro’s innovative Healthcare BPaaS platform that revolutionizes Health Plans' operations by combining cutting-edge technology with a dedicated backoffice staff.
Wipro's BPaaS (Business Process as a Service) platform encompasses a range of services and capabilities that caters to the needs of diverse healthcare plans, such as Medicare Advantage Plans, Part D, Cost Plans, Duals, Special Needs Plans, and Medical Savings Account (MSA).
Government Sponsored Health Plans - Medicare Advantage and Medicaid
Innovative solutions and collaboration with various stakeholders to deliver
high-quality healthcare services to beneficiaries while managing costs and promoting health equity is
need of the hour.
With our core solutions focused towards the Government health plans. The MedAdvantage360 platform offers
a comprehensive Medicare Advantage membership management system designed to enable plans to stay in
compliance and follow the CMS Chapters 2,3,4,5 guidance.
Medicare Plans
MA, MSA,MAPD, PDP, EGWP
SNP, CSNP, DSNP, DUAL
Stand alone part D
Medicaid Plans
Medicaid Plans,
Long Term
Care plans
Markets place /
Exchange plans
Individual On Exchange and Off Exchange
HITRUST Certified integrated Medicare BPaaS Platform to 100+ Health Plans
Provider Sponsored Health Plans
Industry's acceleration towards value-based care and in their quest to capture the premium dollar, the number of health systems who have forayed into development of their own health insurance business has also increased. They have encountered the same difficulties afflicting other health insurance start-ups: Challenges in onboarding & managing Membership, financial reconciliation, and adherence to strict compliance requirement.
With 35+ years of experience and successful AEP management since inception, Wipro's Medicare BPaaS solutions consist of a set of integrated turnkey modules that enables best in class Business Process as-a-Service (BPaaS) services for efficient and effective management of the entire value chain including Enrollment Processing, Member Billing, Fulfilment, Care Management, Claims Processing and Encounter Data Processing etc.
Wipro's Medicare and Medicaid services has served 23 million lives including 350K duals with 99% achievement of financial accuracy.
Direct Contracting Entities (ACO REACH)
With a promise to reduce the health inequity among Medicare beneficiaries, the organization participating in the ACO REACH model are faced with multiple challenges in their value based care journey.
High quality of data and having a single source of truth becomes a key ingredient that can help ACO REACH providers gain insights to deliver quality, efficient care and help build health equity.
With automation at the core, Wipro's web based Member360Lite SaaS solution focuses on providing a one stop shop for ACO REACH participating entities to manage their beneficiaries, provider claims and capitation payments.
Modernization of a leading BCBS Health Plan
Wipro implemented end-to-end BPaaS platform with Enrollment, Membership, Agent commissions & Encounters.
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Leading Medicare Advantage Start-up Plan Implementation
Wipro helped achieve growth objectives and addressed the pressing business needs for Medicare
Advantage Health Plan.
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Medicare and Medicaid Revenue Reconciliation solution
Timely and accurate reconciliation of Medicare and Medicaid enrollment and payments helps health plans to avoid revenue loss and unnecessary penalties. Large volume of CMS data and frequent revisions to payment methodologies and regulations often make the reconciliation process complex