Virtusa Corporation

Recon, Refactor, Replatform (Virtusa’s Triple R)

Managing and maintaining core systems that span the enterprise IT landscape is a herculean task. These systems, typically, decades old and saturated with upgrades, often act as an impediment to digital transformation initiatives – especially when it involves multiple vendors and technologies. Businesses end up on the wrong side of customer experience and lose the opportunity to create newer revenue streams or achieve highly agile processes.

At Virtusa, we understand the challenges in addressing the dual mandate of cost efficiency and innovation necessary for successful digital transformation. With our Triple R methodology, we help organizations re-engineer their Pega applications to integrate with a world that is cloud native and driven by AI, Decisioning, Robotics, and seamless channel integration. By rationalizing and optimizing the existing application stack, we infuse newer capabilities and longevity, along with ensuring high flexibility and scalability.

Conduit

The enterprise application landscape is continuously changing. Getting “locked in” to a technology platform is a risk faced by many large organizations as they adapt existing systems or inherit them through acquisition. Many organizations become dependent on expensive legacy platforms with retiring support, or because of poor technology choices of the past. These platforms are often burdened with technical debt, can duplicate business functionality, and limit your organization’s ability to evolve and grow at the speed your business demands.

Virtusa’s Conduit technology helps you revive business areas where the technology has reached its maximum usefulness and needs to be retired. The solutions provided speed the replacement of legacy technology in favor of a modern Pega Infinity™ platform. Using specialist tools and services, we automate the extraction of legacy functionality and then automatically translate these elements into the key constructs of a new application.

Provider Lifecycle Management (PLM)

A unified platform that modernizes all aspects of your complex provider relationships. With Virtusa Provider Lifecycle Management, you can address the multiple challenges you face in each of these phases and manage your provider network effectively

Product features include

• Robotic Automation with market leading robotic capabilities, where significant processes, specifically around credentialing, are automated and the processes are completed without any human intervention
• Pre-built integrations for both internal and external sources
• Automated roster file management to bulk process roster data from multiple provider organizations, consistently
• Intelligent workflow management to empower organizations to manage multi-departmental workflows and complex provider data structures
• Digital enablement to drive the digital transformation of the Provider & Network Management organizations at payers

Simplifying Appeals & Grievances (A&G) Processing

Operational challenges in A&G processing, like disparate systems, siloed departments, and error-prone manual handling, are hard to overcome. These lead to non-compliance, audit deficiencies, and low member satisfaction – and can cost payers substantial financial penalties and even downgrading of the star rating of plans.

Virtusa’s A&G solution eases the pain payers face in complying with A&G processing. The solution simplifies case management, automates a majority of the tasks, ensures high member satisfaction, and accelerates case resolution. It is equipped with AI-based SLA (Service Level Agreement) determination and appropriate classification. Machine Learning is introduced in the heart of the decision making to enable medical directors to make smarter decisions.