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Horizontal Offerings:

Industry-Specific Offerings:
Health & Life Science Services :

Rising healthcare costs, shortage of skilled labor, increased regulations, accelerating technology costs and thin profit margins pose significant and pressing management challenges for the healthcare industry. The healthcare industry is challenged by an aging population and an irregular supply of financing from the working population and Increasing costs of healthcare delivery.

The Life Sciences industry leverages outsourcing to improve business and operational efficiencies, rationalize functional areas, focus on core functions and improve overall productivity.

RANSI BPO offers payers, providers, life sciences organizations end-to-end BPO services to help them maximize their profitability and productivity. RANSI offers a unique proposition that leverages dedicated business support units, complete HIPAA compliance and continous focus on productivity enhancements with customized Six Sigma processes, Kaizen and Lean methodology. We combine our Consulting, IT and Business Process Management capabilities to offer Business Process Outsourcing solutions for healthcare.

Our medical writing services help in ensuring that the documents for regulatory submissions are of the highest quality and comply with applicable regulations. We provide cost effective drug safety services for pro-active pharmacovigilance by utilizing a fully validated, hosted drug safety database from one of the leading vendors. We can assist in virtually every aspect of laboratory automation - from strategy, planning, and system selection through system implementation, integration, validation, and training.

Service Offerings
Healthcare - Payers

We have have capabilities in solving physician and member queries, with adherence to utmost quality standards. We also helps payer organizations to manage efficient and cost effective network of providers by rendering services around credentialing and benchmarking.

Product Development
  • Actuarial Support

  • - Profitability analysis for portfolio underwritten
    - Forecasting for Reserves
    - Budgeting
    - Risk Analytics and Statistical Modeling for loss estimation
    - Customer Analytics
  • Product Incubation

  • - Plan Loading
Underwriting
  • Pre-Underwriting Support

  • - Compilation of
    - Group Claims History
    - Employee census files
    - Medical History Data
    - Federal Disclosure Report
  • Quote Generation

  • - Rule-based Quote generation based on rating engine
    - Quote issuance to employer / broker
    - Quote binding
    - Plan document generation
    - Certificate of Coverage Processing
Distribution Management
  • Agent/ Broker Selection/ Induction

  • - Profiling & screening
    - Induction logistics
    - Reference & background checks
  • Product Training

  • - Training Needs Analysis
    - Training Content Generation
    - Evaluation Feedback
    - Certification
    - Agent Performance Management
  • Workforce Management

  • - Agency Data Management
    - Time and Effort Tracking
    - Workforce Analytics
  • Agency Commission Management

  • - Sales Analytics
    - Commission Computation
    - Commission Processing
Policy Administration
  • Enrollment

  • - Enrollment Application Processing
    - Data Validation
    - Issuance of Plan Document
    - Issuance of Certificate of Coverage
  • Policy Maintenance

  • - Demographic change request processing
    - Policy Renewal Processing
    - Policy Termination Request Processing
    - Policy Change Request Processing
    - Refund Request Processing
Billing
  • Premium Invoicing

  • - Premium Billing
    - Premium Reminder Processing
    - Follow Up
    - Premium Receipts Processing
    - Premium Accounting
    - Report Generation
  • Policy Reconciliations

  • - Premium Reconciliation with Bank Statements
    - Premium Reconciliations with Employer Statement
    - Report Generation for Regulatory and Statutory Compliance Requirements
Patient Care Management
  • Disease Management

  • - Disease Management Spend Analytics
    - Population Definition through Analytics based on ICD 9 CM, CPT and HCPCS Codes
    - Analytics using Primary Care Physician Reports, Referrals and Authorizations
    - Outbound / Inbound Call Center Support
  • Referrals and Authorization Management

  • - Authorization Request Processing
    - Referrals Updation
    - Outbound Call Center for Referral Verification
    - Inbound Call Center for Auth Verification
Claims Management
  • Mailroom & Imaging

  • - Paper Claims Receipt (UB 92, UB 04 & CMS 1500, ADA)
    - Sorting / Prepping
    - Imaging
    - OCR / ICR
  • Pre-adjudication

  • - OCR Data Capture Validation
    - Claims Data Entry (Hand written Claims)
    - Provider Eligibility Validation
    - Edit Resolution
    - Member Eligibility Verification
  • Adjudication

  • - Coding Verification
    - Edit Resolution (Medical, Facility and Dental Claims)
    - Claims Repricing
    - EOB Processing
    - Member / Provider Communication Processing
    - Aged Claims Reporting
    - Claims Quality Audit
  • Collections

  • - Over-Payment / Under-Payment Analysis
    - Root Cause Analysis
    - Provider / Member Follow Up and Recovery
Provider Network Management
  • Provider Credentialing

  • - Collation of credentialing data like education, peer references, training, malpractice history, past affiliations, etc.
    - Verification of credentials
    - New Provider Profile Upload
    - Ongoing credentialing Support
  • Provider Contract Management

  • - New Contract Uploading
    - Ongoing Contract Maintenance
    - Contract Renewal Support
    - Contract Performance Analysis
Healthcare - Providers
Market Definition & Strategic Planning
  • Medical - Clinical Content Analysis
  • Patient base analytics
  • Utilization and Pay for Performance Analytics
  • Benchmark reporting
  • Legal & mandatory statistics for Regulatory Reporting
Resources & Supply Chain Planning
  • Payor and Supplier Contracts management
  • Contracts Analytics
  • Procurement solutions
  • Human Resource Management solutions
Patient Care & Patient Relationship Management
  • Disease Management

- Predictive Modelling and Analytics on patients with chronic disorders to:
. Design and offer customized Disease Management programs
. Assist in implementing Disease management programs run by Payors and Plan Sponsors

  • Revenue Cycle Management
  • Scheduling & Pre-registration
  • Referral Verification
  • Auth Verification
  • Insurance Verification
  • Charge Capture
  • ICD-9 Coding
  • CPT-4/ HCPCS Coding
  • DRG Coding
  • Claims Data Entry
  • Claims Generation
  • Cash Posting
  • AR Management
  • EOB Processing
  • Patient Balance Follow Up
  • Denial Management
Life Sciences
Research
  • Clinical Data Management
  • Clinical Trial Site Setup
  • Safety Narrative Writing
  • Medical Writing
  • AE Management
  • Regulatory Filings
  • Litigation Case Processing
  • Competitive Intellegence
  • Disease Management
  • Biometrics
  • Drug Safety/ Pharmacovigilance
Marketing & Sales
  • Promotional Artwork
  • 2D & 3D Animation
  • Visualization
  • Medical Affairs Support
  • Sales Force Support
  • Content & Portal Management
  • eLearning
Manufacturing
  • Material Management
  • Manufacturing Ops Support
  • Engineering Services
  • Supply Chain Management
  • Packaging Services
  • Distribution
  • Logistics


Finance & Accounting
HR Services
Helpdesk & Call Centers