Private payer operations
Health Insurers
Benefit controls, provider network visibility, electronic claims, fraud indicators, claims turnaround monitoring, and reconciliation.
Solutions by operating model
Claims and financing workflows designed around your institution
Configure technology and implementation services for the responsibilities, scale, controls, and stakeholders your program must support.
Payers and administrators
Support the work behind coverage, care access, and claims
Population-scale financing
National Health Schemes
Beneficiary coverage, provider administration, large-scale claims workflows, program monitoring, integration, data residency, and public-sector deployment.
Multi-client operations
Third-Party Administrators
Multi-client configuration, configurable benefits, provider management, operational dashboards, claims processing, and reporting.
Care delivery organizations
Give providers a clearer route through payer workflows
Provider networks
Eligibility, submission, and status at network scale
Help connected providers verify eligibility, request preauthorization, submit claims electronically, view claim status, correct exceptions, and reduce paper handling.
- Eligibility verification
- Preauthorization
- Electronic submission
- Claim-status visibility
- Corrections
- Provider oversight
Hospitals and clinics
Connect clinical encounters to administrative requirements
Support facility teams with payer-aware workflows that improve submission completeness and preserve the connection between services, claims, and invoices.
- Member verification
- Benefit visibility
- Structured claims
- Invoice preparation
- Submission tracking
- Operational reports
Public programs
Government and development programs
Support health financing, social protection, universal health coverage initiatives, data integration, program reporting, and local capacity development.
Program considerations
- Beneficiary scale
- Provider administration
- Data residency
- Public-sector deployment
- Interoperability
- Program monitoring
- Local capacity
- Operational sustainability
Find the right platform and delivery model for your organization
Talk with Pillarsis about your program, provider network, current systems, claims workflows, and implementation priorities.