Healthcare payer solutions
Improve member satisfaction, strengthen compliance, and reduce operational overhead with HW.Tech’s AI-driven healthcare payer solutions.
We design and build scalable systems to help health plans and insurers automate administrative workflows, streamline claims and billing processes, and turn fragmented data into actionable insights made in real-time. Experience an improvement in performance and efficiency across the entire payment ecosystem.
Team of product creators trusted by Fortune 500 companies
Our healthcare payer solutions
With almost two decades of custom software experience, HW.Tech helps transform operations through AI-driven solutions. We deliver healthcare payer solutions software to automate manual tasks, integrate critical systems, and support smarter decision-making across the healthcare payment lifecycle.
AI-powered member support chatbots
Offer round-the-clock, personalized member assistance using conversational AI. These chatbots use NLP to handle routine inquiries with 97% accuracy, provide benefit details, and guide members across digital channels. Reduce call center volume, improve satisfaction, and experience a potential 30% reduction in operational member service costs.
AI-assisted medical billing software
Accelerate billing preparation and submission with AI, ML, and RPA. The solution helps minimize errors, ensure compliance with coding standards, and reduce the time by 60% needed to process complex claims. Get accurate submissions and experience a 44% savings in pharmacovigilance costs.
Claims automation systems
Stay ahead of claims backlogs and promote efficient reimbursements with claims processing automation platforms built on AL, ML, and NLP models. These solutions help healthcare payers manage high claim volumes during peak periods, verify coverage instantly, and track real-time processing outcomes. Experience an automated 2-hour reimbursement process compared to a standard 4-day timeframe.
Fraud detection and prevention platforms
Identify and stop fraudulent claims faster using ML, NLP, and graph neural networks. We develop AI-powered fraud detection and prevention systems for healthcare payers to boost fraud detection. Get 70% fewer false positives and experience a 79% reduction in investigation time. Minimize financial losses and ensure compliance with regulatory standards.
More solutions
Intelligent provider network management
Maintain accurate directories much faster with the top-of-the-line AI solution. The AI-powered provider network management system for healthcare payers has 60% of ePAs processed in just 2 hours. The solution brings a 73% auto-approval rate for standard requests and reduces the time needed to update provider data into reliable listings.
Smart member outreach automation
Reach more members, more effectively, without overloading your team. We develop AI-driven outreach tools to personalize communication across SMS, chat, email, or apps. The solution uses ML models to analyze member data to identify who to contact, when, and how. Help payers engage high-risk individuals, close care gaps faster, and reduce churn.
AI-enhanced data integration
Unify fragmented healthcare data through real-time API integration. The solution normalizes records, aligns systems, and creates a shared view across claims, EHRs, and partner platforms. It uses API-driven data fabrics and AI to integrate disparate sources into a cohesive whole. Break data silos and cut administrative costs by up to 25%.
Advanced virtual care models
Offer smarter, more connected virtual care experiences with help from AI. These solutions support symptom triage, remote monitoring, and care coordination. Guide members to the right care setting, improve chronic disease management, and keep digital and physical care seamlessly in sync.
Partner with a leading healthtech development company
Full-stack software development services
We provide end-to-end software development, creating cutting-edge solutions to align with your business goals and project requirements.
Artificial Intelligence solutions
With AI integration, your tool becomes smarter, faster, and more efficient, allowing you to reduce operational costs and adhere to stringent regulations.
Web & mobile app development
We help you build a solid presence across the web and mobile, allowing you to gain more touchpoints with your staff and patients, reach them wherever they are, and deliver superior patient care.
Consulting services
Book a free consultation with our engineers and get your questions answered by industry experts. We will guide you through the entire software development process and help you make informed decisions to set your project up for success.
Legacy software modernization
We perform cloud integration, code refactoring, database modernization, security enhancements, and related services to turn your outdated system into a modern, scalable solution.
Cybersecurity services
We implement multi-factor authentication, end-to-end encryption, regular security audits, intrusion prevention systems, and other measures to protect your business against threats.
PoC development
We will build a proof of concept to validate your idea and identify potential roadblocks early on. It will help you gather feedback from stakeholders and users and mitigate risks before committing time and money to a full-fledged digital product.
DLT development
The technology can help you prevent counterfeit drugs from entering your supply chain, maintain a transparent record of every transaction, and track pharmaceuticals from raw materials to finished products for early detection of quality deviations.
Regulatory compliance
Our engineering team develops digital products that adhere to industry standards and regulatory compliance requirements, including HIPAA, GDPR, FDA, the EU Artificial Intelligence Act, ISO 27001, ISO 25010, and other frameworks.
93%
of our clients recommend our services (according to our customer survey)
800+
seasoned software developers with a strong coding background
20
years in business
200+
completed projects
18
global offices
4.5
years average team tenure
Learn how our healthcare payer services help companies like yours
Who we work with
We collaborate with various organizations across the healthcare payer ecosystem to enhance care affordability, streamline operations, and improve health outcomes through technology.
Private and public health insurance providers
Managed care organizations (MCOs)
Pharmacy benefit managers (PBMs)
Accountable care organizations (ACOs)
Health maintenance organizations (HMOs)
Population health management firms
Healthcare analytics and data service providers
Medical billing and claims processing companies
How HW.Tech support the healthcare payer technology?
With HW.Tech’s solutions, you can open many opportunities for your business:
01
Streamline core operations like eligibility verification, billing, and claims management
02
Enhance member experiences with personalized digital tools and self-service portals
03
Automate repetitive workflows to reduce manual errors and administrative costs
04
Ensure 100% compliance with rapidly changing regulatory requirements
05
Access in-depth data analytics to make informed decisions faster than your competitors
06
Support value-based care models with better data visibility and performance tracking
Tech stack for healthcare payer software solutions
We use the latest technologies and industry best practices to build advanced software solutions to optimize claims processing, risk analysis, and member engagement for healthcare payers.
Programming languages and frameworks
Data solutions
DevOps
Big data &
machine learning
machine learning
Cloud
Monitoring & observability
Tap into our domain expertise to develop AI-driven solutions for operations, compliance, and member outcomes.
Why HW.Tech
100% compliance
We create software with compliance in mind, ensuring adherence to HIPAA, FDA, GDPR, the EU Artificial Intelligence Act, ISO 9001, ISO 27001, and ISO 25010.
5
years average client relationship
Your IP, our support
You gain access to a centralized project dashboard with regular progress reports, and all upcoming expenses are discussed in advance.
5K+
tech talent pool worldwide
Uncompromised quality
ISO 25010-compliant and AWS-certified, our pharmaceutical software delivers superior performance while helping you achieve your business objectives.
80%
customer return rate
Visibility and control
You retain full intellectual property rights to your product(s). We also provide post-launch maintenance and support with regular security audits.
93%
customer satisfaction score
Client testimonials
Choose a suitable engagement model
End-to-end development
We take full responsibility for your product, from initial concept to final delivery, working closely with stakeholders at every stage of the development process.
Dedicated team
We dedicate a team to your project and manage it on your behalf, freeing up your time for core business activities.
Team augmentation
We help you bridge the talent gaps by integrating our brightest minds into your in-house team while enabling you to maintain full control over your project.
FAQ
How does HW.Tech help healthcare payers use AI effectively?
We automate time-consuming tasks like claims processing, billing, and prior authorizations. Our AI tools also catch billing errors, flag fraud risks, and support faster decisions, reducing cost and cutting processing time from days to hours.
What makes HW.Tech a good fit for healthcare payers?
We build scalable systems designed specifically for payer operations. That includes claims automation and provider data cleanup for member support bots. We help payers work faster, smarter, and compliantly without bloating the tech stack.
Can HW.Tech improve the member experience too?
Yes. Our AI-driven platforms handle common requests 24/, like claim status, ID cards, or billing questions. That means less waiting for members and fewer calls for your team. We also offer predictive outreach tools to reduce missed payments and improve adherence.
