Healthcare Payers
Outsourcing Solutions for Healthcare Payers
We help payers tackle their specific business and retention challenges. From open enrollment to service billing questions and payments, we enhance the member experience across your entire lifecycle with custom-built, HIPAA-compliant contact center and recovery solutions.
Not a healthcare payer? Learn about our solutions for providers.
Customer Care and Retention
Our call centers increase operational efficiency and member satisfaction through a member-first approach. Healthcare agents consult and educate callers on their health plans, network options, and billing questions with processes focused on resolving challenges and positively representing your brand.
We can handle inbound and outbound calls for:
- Open enrollment staffing
- Coordination of benefits
- Health plan comparison
- Prescription plan coverage
- PCP inquiries and changes
- ID card requests
- Claims inquiries
- Enrollment and eligibility verifications
- Transportation arrangements
- Updating and reconciling account information
Accounts Receivable Management
Windham’s revenue lifecycle management approach has been refined from over 35 years of successful collections and recovery experience. Our 1st and 3rd party recovery programs help you increase your revenue and member and group satisfaction while reducing costs. Our sustainable, flexible processes focus on operational improvements that enhance efficiency and the profitability of your receivables, including:
- Member and provider overpayments
- Member deductibles
- Group and member premium recovery
- Pharmacy retroactive benefits
- Coordination of benefits
Our solution emphasizes:
- Member-first approach centered on compassionate contact and resolution
- Customized workflows supported by client-specific training
- 100% on-shore, U.S. based services
- Member correspondence series
- Advanced technology with multi-channel contact options (phone, SMS/text, etc.)
- Manual and automatic skip tracing
- Heightened compliance management system that touches and monitors every facet of our process
- Protecting your brand’s image and reputation during the collection process
- HIPAA compliance