Mayuri Takawale

Simplify Healthcare

Simplify Healthcare is focused on powering connected benefits and provider journeys on a foundation of clean and rich product, benefits, and provider data across the Payer ecosystem through our end-to-end platform Simplify Health Cloud™. Simplify Health Cloud™ is a scalable, enterprise-grade, secure, configurable, and compliant platform aimed at maximizing existing investments in Core-Admin systems. Packaged on the Simplify Health Cloud™ — Benefits1™, Provider1™, Service1™, Claims1™, and Experience1™ provide Payers with discrete and precise solutions to complex problems and opportunities in delivering a rich set of product, benefits, and provider data. Benefits1™ — the single source of truth for product and benefits data to catalog product and benefits data in a central repository, fulfill all compliance and mandated document generation, and integrate with sales, actuary, and downstream systems. Provider1™ — a master record of provider data that enables a flexible hierarchy for storing provider data and their relationships. It performs enables provider onboarding, credentialing, contracting, reimbursement models, roster file management, and directory management. Service1™ — delivers an intelligent benefits inquiry experience that enables customer service representatives to handle and resolve all benefits inquiries. It uses NLP and AI to provide accurate responses to benefit inquiries from members, providers, employers, and brokers. Claims1™ — delivers a foundation to integrate benefits and provider data into the claims and eliminates manual keying of benefits and provider configuration in the claims system leading to claims accuracy, reduced claims recoveries, and faster time to market. Experience1™— delivers a dynamic data-driven digital experience using a rules-driven solution to send and display benefits and provider content to a Payer's digital front door and personalize offerings of benefits and provider content to members based on metadata.