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EGS - CMS in Healthcare (Payer and Provider Support)

Vendor Analysis

by Vicki Jenkins

published on Jul 08, 2015

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Report Overview:

EGS is a global customer service organization, delivering outsourced solutions for customer and financial care. It employs ~40 in ~70 locations in 10 countries. EGS' customer management services (CMS) include answering product related enquiries, technical support, up-sell/cross-sell, and social media support. Its financial care includes accounts receivable management, revenue cycle management, and order to cash support. It is a privately held company headquartered in Plano, Texas.

Who is this Report for:

NelsonHall's CMS in healthcare industry sector profile on EGS is a comprehensive assessment of EGS' healthcare (payer and provider) sector customer management services (CMS) offerings and capabilities, designed for:

  • Sourcing managers monitoring the capabilities of existing suppliers of CMS to serve the healthcare sector and identifying vendor suitability for CMS RFPs
  • Vendor marketing, sales and business managers looking to benchmark themselves against their peers
  • Financial analysts and investors specializing in the support services sector.

Scope of this Report:

The report provides a comprehensive and objective analysis of EGS' healthcare sector CMS offerings, capabilities, and market and financial strength, including:

  • Identification of the company's strategy, emphasis and new developments
  • Analysis of the company's strengths, weaknesses and outlook
  • Revenue estimates
  • Analysis of the profile of the company's CMS healthcare sector customer base, including the company's targeting strategy and examples of current contracts
  • Analysis of the company's healthcare sector CMS offerings and key service components
  • Analysis of the company's delivery organization including the geography of delivery locations used for CMS healthcare sector clients.

Key Findings & Highlights:

Key merger activity occurred in 2012 when APAC and NCO merged. Expert Global Solutions (EGS) became the holding company for APAC and NCO. APAC had its roots in the CMS BPO market, while NCO had its roots in the accounts receivables management (ARM)/collections BPO market. The company now goes to market as EGS.

The majority of EGS' healthcare BPO clients are based in North America. The company provides a range of offerings to healthcare payers, covering support for:

  • Enrollment
  • Benefits and eligibility
  • Claim status
  • Claim adjustments/back office
  • Pharmacy benefits managers (PBM).

Examples of provider core services used by EGS' clients include:

  • Eligibility patient advocacy liaison services (EPALS)
  • Extended office services (EOS), includes insurance and self-pay support
  • Out of state Medicaid billing services
  • Revenue cycle management.

EGS has delivery centers in support of its healthcare clients in North America, the Philippines, and Latin America.

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