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 4Sight Technologies - Industries


The healthcare industry is one of the fastest-growing sectors with a critical need for new applications and customized technological solutions.

4Sights' capabilities and areas of expertise include:

  • Payer administrative and information system modernization: Domain expertise in core data management, data warehousing, internet and intranet web portals for commercial payers including, enrollment, premium billing, member services, claims processing, provider relations, printing, and fulfillment; for government health plans such as Medicare and Medicaid in the U.S., implementation of transformational solutions for numerous mission critical functions.

  • Regulatory Compliance Transaction Processing: Subject matter expertise in HIPAA compliance, 4010 vs 5010 EDI Transaction format, data conversion, ICD9 / ICD 10 coding requirements, and CMS audit regulations.

  • Member and patient engagement portals: Architect solutions and manage numerous healthcare portals, member portal, employer portals, broker portals, and provider portals for health plans and coverage services.

  • Claims recovery and fraud prevention: Provide consulting services for healthcare payers recovering lost payments due to improper claims. Provide anti-fraud solutions that help payers detect, remedy, and prevent claims fraud.

  • Predictive modeling and analytics: Domain expertise in predictive analytics, business intelligence, and resource optimization tool offering optimal projections, "what if" capabilities, and consistent modeling for health payers.