Healthcare payer solutions

Speed healthcare payer processes, support compliance requirements and boost member experience with intelligent content solutions.

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Discover Hyland’s healthcare payer solutions

Today’s healthcare payers need connected information and effective business processes to support members on their quest for positive health outcomes. Here’s how Hyland’s payer solutions can help:

Prior authorization

Speed response times with AI-powered intelligent document processing. Easily capture, classify and extract data for prior authorization reviews.

Optimize processes to adhere to the Centers for Medicare & Medicaid Services rules and avoid penalty fines.

Effectively track and report on compliance with prior authorization requirements.

Reduce the risk of a PHI breach by eliminating the manual processing of sensitive and private information.

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Member experience and support

Speed new member enrollment by automatically routing information to the right workers and systems.

Reduce average handle time and minimize steps by linking your Hyland healthcare payer solutions to member records in Salesforce.

Deliver 24/7 self-service access to enrollment cards, explanation of benefits (EOBs), policy info and more.

Leverage unstructured data to support the member-360 data platform vision.

Support health outcomes with faster, data-driven decisions powered by a complete set of information.

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Claims administration

Centralize claims information for visibility in core systems.

View, manage and share content among claims adjusters and external third parties quickly and easily.

Automate processes for standard claims and build business rules to escalate complex claims.

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Appeals and grievances

Simplify the collection, storage, routing and management of appeals and grievances.

Automatically route claims appeals and documents to the right workers for immediate attention.

Increase process efficiency and meet compliance timelines.

Easily manage requirements for Medicare, Medicaid and commercial providers with configurable rules per the state, SLAs and mandatory or voluntary actions.

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Scalable and flexible payer platform

Empower enterprise IT to build tailored, customized healthcare payer solutions.

Deliver effective, personalized user experiences with open standards and open APIs.

Eliminate legacy ECM systems with a future-ready infrastructure driving resiliency, agility and efficiency.

Innovate faster and reduce costs with cloud-native healthcare payer solutions.

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Omnichannel communication

Create and manage personalized member communications for omnichannel delivery.

Share timely messages around enrollment, claims, health management and more.

Combine data from multiple sources to create the most accurate and up-to-date correspondence.

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Speed time to market and simplify IT with core system integrations

By connecting Hyland with your core healthcare payer software, your organization extends the value of your technology investment to empower agility and member support.

Gain a complete view of member or provider information with Hyland’s integration with Cognizant’s TriZetto healthcare products, Salesforce and more.



Benefits of integrated healthcare payer technology

Speed payer processes and increase accuracy, productivity and customer service.

Insurance payer uses Hyland for low-code flexibility

Hyland’s solution experts go “over and above” to help Priority Spectrum Health fix issues, improve workflows and become more efficient.

Empower your people to deliver their best with Hyland

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