With years of experience helping healthcare companies streamline operations and improve efficiency, ESTA understands the importance of quality and the value of our customers' time. Our innovative processes, combined with focused IT, targeted analytics and lean technology, enable us to optimize investments and increase profits for our customer base. We've created an integrated end-to-end approach capable of improving the quality of patient care while reducing waste. In short, we've created a smarter system.

There's no question that healthcare companies face a host of challenges in today's marketplace. The spiraling cost of care, reduced profit margins and pressures from government reforms spell out a challenging future for the industry. At ESTA, we believe many of these issues can be overcome by improving workflow and administrative processes. ESTA's process improvements and applied technology ensure an integrated system where patient satisfaction remains high and costs and profits are in balance.

SERVICE OFFERINGS

We provide comprehensive services including new business and underwriting, policyholder services and claims administration, as well as adjudication, healthcare fraud and abuse investigation, subrogation and recoveries, clinical research, medical billing and coding, IT application development support, health economics and informatics.

Claims Administration: By optimizing administrative processes, ESTA delivers products like claims capture and management, identification and management of overpaid claims, processing and adjudication. We provide end-to-end claims administration services including claims receipt, imaging, OCR, data entry, error resolution, medical review processes and real-time adjudication focused on reducing cost per transaction.

Cost Management: With extensive experience in analyzing business processes, ESTA offers solutions in fraud and abuse investigation, subrogation services and overpayment identification and recoveries. We use sophisticated analytics and statistical tools to analyze claims customized to specific plan criteria and to identify recovery potential.

Health Economics: With a solid commitment to quality, ESTA provides leading solutions in predictive modeling, disease management and outcome measurements. Our advanced statistical models and data mining queries unearth hidden trends and patterns from millions of claim lines of data to aid in decision-making.

Membership Management: ESTA provides highly trained and talented experts across all aspects of membership management including enrollment, premiums and credentialing. We offer options from multiple delivery centers, adopting a solution-centric approach to member queries that increases customer satisfaction.

Process Transformation Services: ESTA has the resources, tools and domain expertise to partner with payers to drive efficiencies, improve key business metrics and deliver business impact. We leverage a proprietary tool set employing Lean Six Sigma, Smart Enterprise Process, combined with specialized reengineering resources, to transform your business processes.

At ESTA help our customers improve their bottom line by reducing administrative and medical costs, increasing member enrollments and enhancing customer satisfaction. We provide world class quality services, coupled with continuous process improvement and innovation, through our Lean Six Sigma rigor. We believe our partnerships allow our customers to better focus on governance structure, data privacy and protection.

To learn more about how ESTA can help your business grow, browse through the entire portfolio of the Solutions We Offer.

  • Claims Administration

    Cost Management

    Health Economics

    Membership Management

    Process Transformation

  • Forward-looking organizations closely examine their back-office structure to reduce costs, streamline operations & increase revenues. ESTA's solutions help clients reach their targets quickly and cost-effectively by implementing solutions tailored to meet their needs and help make their ambitious goals reality. ESTA's Enterprise Innovation solutions offer the expertise to deliver a back office that's as strong as the front office. We offer exceptional capabilities in:

  • Order & Contract Management

    Financial Planning & Analysis

    Revenue Cycle Management

    Benefits Administration

    Expense Control Management