Navigate today’s most pressing health industry challenges with a leading global expert by your side.
Meet growing needs for innovative insurance solutions while increasing operational health and improving compliance.
Deliver on the promises of the past and create smart solutions for the future.
Manage complex risks using data-driven insights, advanced approaches, and deep industry experience.
This is a place where your ideas and insights make an impact. Where an independent, entrepreneurial spirit is an advantage. And where diversity of thought and experience makes us who we are.
Data-driven insight. Deep expertise. Transformative innovation. Since 1947, Milliman has delivered intelligent solutions to improve health and financial security.
Whether you are overcoming current challenges, or looking to optimize operations to better compete tomorrow, we can help. Milliman offers complete operational consulting services including due diligence, turnaround practices, and performance improvement plans. Combining deep industry data, seasoned analysis, and expertise in the Indian health insurance market, we recommend improvements and efficiency measures to help achieve operational goals.
By increasing the productivity and accuracy of your claims operations, Milliman’s clinical consultants help you reduce risk and cost. We conduct operational audits of claims function for health insurance companies and third-party administrators. These audits combine on-site visits, staff interviews, claim file audit and data analysis to identify ways to improve efficiency and save money. We also analyse IT systems to identify potential areas of improvements.
Our innovative approach to claims process reviews includes retrospective claims data analysis using clinical, contractual and utilization rules to identify claim errors and leakage. Such comprehensive audit helps identify opportunities for automation.
Our sample audit of claim files by clinical experts relies on long experience and evidence-based clinical criteria to identify suspect claims and savings opportunities. The detailed audit confirms compliance with protocols, as well as consistency across personnel in decision making.
Effective underwriting is key to health insurance success. Retail medical underwriting requires carefully evaluating the complex personal, social and clinical profile of a proposer to ensure appropriate risk selection. Maintaining consistency and accuracy is key. Our experienced clinical consultants conduct operational audits that include on-site visits, staff interviews, SOP reviews, file audits and decision support system reviews. We help you answer questions such as:
By assessing consistency and rigour in your underwriting practices and systems, we identify opportunities for efficiency, automation and compliance with India’s legal and regulatory requirements. We help in building capacity through training, formulating an underwriting approach and automated risk assessment process development.
We summarise different methodologies adopted by healthcare stakeholders to measure medication adherence, and offer some advancements in standardizing this critical metric.
With an urgent need to bring cost inflation into a sustainable range, we examine best practices in reducing spending, while maintaining or improving patient outcomes.
With the ongoing COVID-19 pandemic, it has become all the more important for insurers to manage their claims and expenses.
Milliman can help clients improve their administrative performance by conducting company function-by-function comparisons of administrative performance and staffing levels versus competitors and peers, and recommending…
Sophisticated population health analytics enable insurers to make smarter and more informed decisions on financial trend drivers, and can help medical management departments by more effectively allocating disease and care…
The literature shows that a disease management programme is not a guarantee of cost savings, but in addition to community health improvements and improved clinical outcomes, desired cost savings can be realised if the…
Gain powerful insights into the health and risk profile of your employees—and give them the ability to monitor their own health and wellness. Flexible, secure, and cloud-based MillimanHRA provides objective, in-depth intelligence for better health.
We’re here to help you break through complex challenges and achieve next-level success.