Healthcare Payers are undergoing a rapid AI-powered digital transformation. Chief Operating Officers, Chief Digital Officers, Chief Information Officers, and VPs of Applications are under constant pressure to automate processes, enhance operational efficiency, and improve member experiences.
This transformation is being fueled by modern enterprise platforms—spanning claims, care management, appeals & grievances, provider lifecycle management, CRM, ERP, HR, and portals—now deeply integrated with AI, GenAI, and workflow automation capabilities.
CRM: Salesforce enables omnichannel member engagement and agent productivity.
Claims Management: Facets, QNXT, and HealthEdge drive payment accuracy, compliance, and efficient adjudication.
ERP: Oracle ERP Cloud and SAP S/4HANA streamline finance, procurement, and HR operations.
HR & Workforce Management: Workday optimizes human capital management, payroll, and workforce planning.
Provider Lifecycle Management (PLM): Newgen PLM, a leader in provider onboarding, credentialing, and monitoring.
Appeals & Grievances (A&G): Newgen ANG supports compliance-driven appeals management and complaint resolution.
Care Management & Population Health: ZeOmega, Medecision, and Innovaccer enable risk, utilization, and health program management.
Portals: Provider, broker, member, and employee portals enhance self-service and reduce call center volumes.
Healthcare payers are embedding AI and GenAI into every layer of operations—claims auto-adjudication, predictive analytics for fraud detection, conversational AI for member services, and intelligent automation to streamline back-office functions.
Enrollment & Eligibility: Automated onboarding, eligibility checks, and enrollment via APIs.
Claims: AI-enabled intake, validation, and auto-adjudication to reduce turnaround times.
Provider Lifecycle Management: Automated credentialing, re-credentialing, and performance analytics.
Appeals & Grievances: AI-based categorization, routing, and compliance tracking.
Care Management: Predictive risk stratification and AI-driven care gap closure.
Population Health: Community health interventions powered by AI-driven insights.
Portals: Integrated self-service portals for providers, members, and brokers.
GHIT Digital is a trusted partner for healthcare payers, combining deep healthcare domain expertise with proven IT services and technology consulting capabilities.
Our core business is the implementation of Newgen Software solutions purpose-built for healthcare, including:
NewgenONE Digital Transformation Platform
Newgen Provider Lifecycle Management (PLM)
Newgen Appeals & Grievances (ANG)
We specialize in delivering end-to-end workflow modernization by integrating Newgen platforms with enterprise systems like Salesforce, Oracle, SAP, and Workday.
By leveraging AI-first strategies, process automation, and platform integration, GHIT Digital enables payers to achieve:
Cost optimization through automation and straight-through processing
Regulatory compliance with industry standards and mandates
Superior member and provider experiences via digital-first engagement
Ready to explore how our AI-powered, advanced Low-Code technology platforms can transform your healthcare Payer (P1) and Provider (P2) organization in:
A) ECM – Content Management
B) BPM – Workflows Management
C) CCM – PHI / HIPAA Communication Management
D) PLM – Provider Lifecycle Management
E) ANG – Appeals & Grievances Management
F) EHR Connector – FHIR
G) EHR Archival – EAMS
We invite you to connect with us for a no-obligation discovery conversation or DEMO.
???? Call us: +1 201.792.8924 or +1 646.734.6482
???? Email us: Monika@GHIT.digital
We also welcome your RFPs/RPQs for timely review and response.
#GHIT #GHITDigital #RFP #Newgen
