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Firstsource - Healthcare Payer BPS

Vendor Analysis

by Sven Lohse

published on May 29, 2019

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Report Overview:

Firstsource has served commercial sector payers in the U.S. for approximately a decade and began its work in this segment with document processing and with claims processing. Firstsource counts as clients 5 of the top 10 health insurance carriers and many smaller payers.

Who is this Report for:

NelsonHall’s profile of Firstsource’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.

Scope of this Report:

The report provides a comprehensive and objective analysis of Firstsource’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.

Key Findings & Highlights:

Firstsource has served commercial sector payers in the U.S. for a decade and began its work in this segment with document processing and with claims processing. It counts 5 of the top 10 health insurance carriers and many smaller payers as clients. NelsonHall estimates that Firstsource payer BPM revenue from commercial payer clients in calendar year 2018 was approximately $41m. Revenues from government clients in 2018 totaled $5m, mostly from Texas and Ohio. Particular expertise is offered in:

  • Document capture and data entry
  • Claims management
  • Member engagement.

Firstsource typically serves clients using the client’s platforms and tools, although it can deploy its own proprietary software in some cases. IT enhances its offerings by using, for example:

  • This automation and workflow tool enhances data entry by identifying missing data and reducing errors
  • Sympraxis, workflow platform supported by a global CoE based in India.

Firstsource delivers services to U.S. healthcare payers from approximately half a dozen delivery centers located in KY, IL, CO, UT, and IN. These are supported by several delivery centers in India that mainly serve to support data capture and entry and document administration.

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