Virtusa Launches Solution to Transform the Provider Lifecycle Management Process for Healthcare Companies


Virtusa Corporation (NASDAQ GS: VRTU), a global business consulting and IT outsourcing company that accelerates business outcomes for its clients, today announced its Provider Lifecycle Management (PLM) solution, which focuses on overcoming the Healthcare Payer challenges of end-to-end provider management – from contracting and credentialing, to long term retention and relationship management. Built on the Pega® Platform from Pegasystems, the PLM solution reduces improper claims payments due to delayed configuration of providers, ensures greater data quality, reduces provider onboarding time, eases operational efficiencies, and enables transparency while helping to improve NCQA / CMS ratings.


“There is a great need in the healthcare industry for a PLM solution. Providers are frustrated with the lack of transparency and the disjointed ‘touch-points’ in the payer/provider/patient lifecycle,” said Murtuza Mukadam, vice president, global head of Healthcare Strategy and Solutions, Virtusa Corporation. “We’re already seeing tremendous results with our implementation of Virtusa’s PLM solution. The solution allows our clients to work more efficiently with their network of providers, which helps improve the overall quality of care and service they provide to their members. Helping patients access the right care at the right time in an appropriate setting will surely bring a huge advantage to care providers.”

With the PLM solution, focus is set on the complete end-to-end cycle of provider management, including network assessment and development, contracting, credentialing, as well as demographic and pricing configurations. The solution provides the following key benefits:

  • Reduction in onboarding time of providers by eliminating manual processes for contracting and credentialing
  • Elimination of CMS Fines while automating data collection for audits, including eliminating tax ID and W2 mismatches
  • Cost Savings by introducing automated self-service portals for business users
  • Operational productivity with the use of automated primary source verification (PSV) processes, eliminating licensing and maintenance costs for existing legacy systems

The solution has been built on the Pega Platform, a unified platform that drives superior customer engagement and operational excellence by combining industry-leading case management, BPM, robotic automation, AI and decisioning, mobile, and omni-channel UX. The platform connects across system and organizational silos, simplifying the customer experience and improving operational efficiency.  Changes and new design capabilities in Pega are done without coding, while its cloud-ready architecture deploys end-to-end experiences that change at the pace business demands.

“Healthcare organizations struggle to provide a seamless patient journey that traverses a complex and disconnected ecosystem,” said Susan Taylor, global business line leader, Healthcare and Life Sciences, Pegasystems. “This new PLM solution from Virtusa leverages the Pega Platform to enable organizations to intelligently and rapidly respond to changes in provider relationships. This improves the healthcare experience for consumers, while streamlining processes and lowering costs.”

Virtusa’s Healthcare group has received numerous analyst and industry recognitions including in Everest Group’s Performance, Experience, Ability, Knowledge (PEAK) Matrix for both its Healthcare Provider IT Services and Healthcare Payer Big Data and Analytics IT Services. Virtusa was also the recipient of Frost & Sullivan’s 2014 Global System Integration in Healthcare Product Line Strategy Leadership Award. The company was recently recognized as a leader among BPM service providers by analyst firm Forrester Research in The Forrester Wave™: BPM Service Providers, Q4 2016.

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