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Sutherland - Healthcare Payer BPS

Sutherland - Healthcare Payer BPS

Who Is This Vendor Assessment For?
NelsonHall’s profile of Sutherland’s Healthcare Payer Business Process Services (BPS) is a comprehensive assessment of service offerings and capabilities designed for:
• Sourcing managers monitoring the capabilities of existing suppliers to deliver business process services to healthcare payers
• Vendor marketing, sales and business managers looking to benchmark themselves against their peers
• Financial analysts and investors specializing in the support services sector.

Key Findings & Highlights
Sutherland Global Services is a private, global BPS company headquartered in Rochester, NY. NelsonHall estimates that the company generated approximately $1.3bn in calendar year 2018. The company’s government and healthcare vertical clients generate approximately 15% of total company revenue. Within the healthcare vertical Sutherland serves payers, providers, and life sciences clients. Sutherland reports that 7 of the top 10 payers are clients. NelsonHall estimates that Sutherland payer BPS revenue from commercial clients in calendar year 2018 was approximately $55m. NelsonHall estimates that revenues from government sector clients over calendar year 2018 were approximately $5m.
Sutherland offers particular expertise in:
• Provider credentialing and service
• Sales, member lifecycle management and health insurance exchange enrollment.
• Claims processing (especially adjudication)
• Billing and collections (charge capture, receivables management).
Sutherland employs healthcare payer BPS resources in 12 locations across the U.S., India, and the Philippines. These operations employ approximately 2,250 people, with approximately 900 in provider data management, 1,100 in member engagement, and approximately 250 in claims administration.


Scope of the Report
The report provides a comprehensive and objective analysis of Hexaware’s offerings, capabilities, and market presence in support of business process transformation through the application of healthcare payer BPS including the company’s:
• Offerings and key service components
• Delivery organization
• Customer base, including the company’s targeting strategy and examples of current contracts (where available)
• Revenue estimates for healthcare payer BPS
• Strategy, emphasis and new developments in support of healthcare payer BPS
• Strengths and weaknesses.


1. Introduction and Strategy
2. Offerings and Capabilities
3. Delivery Network
4. Clients
5. Strengths & Challenges
5.1 Strengths
5.2 Challenges

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