Healthcare Industry Solutions

Ensure compliance, cut costs, and streamline operations with our ServiceNow-powered solutions. Our accelerators eliminate inefficiencies, mitigate fraud, and enhance patient satisfaction, while reducing administrative burden and regulatory risk.

CLAIMS EXCEPTION WORKSPACE

CHALLENGE

  • Manual claims processes create inefficiencies, leading to 10-20% of claims exceptions and over $10 per claim in unnecessary costs.

  • Compliance issues arise from unstructured data, making audits difficult.

  • Claims teams struggle with outdated systems that don’t integrate with modern tools.

IMPACT

  • Delays increase operational costs.

  • Patient & provider frustration leads to lower NPS scores.

  • Risk of non-compliance penalties due to lack of tracking.

HOW OUR SOLUTION HELPS

  • Automates claim exception workflows, reducing processing time by 30%.

  • Provides structured data for real-time tracking & compliance audits.

  • Seamlessly integrates with your existing claims management systems.

FRAUD, WASTE, & ABUSE WORKSPACE

CHALLENGE

$100 billion is lost to healthcare fraud, waste, and abuse (FWA) each year.
Regulators are cracking down. Are your systems prepared to detect and prevent fraud before it impacts your bottom line?

  • Manual fraud detection is slow and reactive, leading to missed fraudulent claims.

  • Siloed data makes cross-checking transactions difficult, increasing the risk of overpayments.

  • Regulatory audits are becoming more stringent, requiring transparent, real-time fraud tracking.

  • Lack of structured automation means teams waste valuable time on preventable losses.


HOW OUR SOLUTION HELPS

esolutionsONE’s Fraud, Waste, and Abuse (FWA) Workspace is a versatile, integrated solution designed to streamline enterprise-wide investigations and maximize value realization

  • Never miss a critical step with a structured, find, frame, and fix approach.

  • Eliminate manual inefficiencies that slow down fraud detection.

  • Unify fraud case management with a single-pane-of-glass view.

  • Increase transparency and collaboration across teams.

  • Improve efficiency and accuracy while ensuring governed data tracking.

  • Reduce financial exposure and support compliance with clear reporting.

Are you confident in your fraud prevention strategy? Get expert insights to ensure compliance, reduce waste, and streamline investigations.