Company Fact Sheet

Adaptis Overview

Founded in 1996, Adaptis provides business process outsourcing (BPO) to health payers offering Medicare Advantage, Medicaid and commercial lines of business. Our customizable BPO solutions are tailored to meet each client’s specific needs.

Adaptis offers a choice of on-shore, off-shore, and blended-shore healthcare claims processing solutions through our regional operations center in Yakima, WA, and our majority-owned subsidiary, Tēla, located in Pune, India. Our 700+ person global workforce serves over two dozen clients. We process more than 30 million transactions per year for 1.2 million covered lives, and our corporate headquarters are located in Seattle, WA.

Why Choose Adaptis for your Healthcare BPO Needs?

Our employees have deep healthcare, technology and consulting expertise. We believe that these employees –their knowledge, experience, and commitment to excellence– are our first and best advantage in the competitive healthcare BPO landscape. We are deeply invested in their continued development and we offer ongoing training, educational benefits, and other advancement opportunities.

We have selected the flexible, top-rated Qnxt™ system, from TriZetto, as the platform for our customized healthcare claims processing services. The Qnxt system continues to be highly rated by industry analysts such as Gartner and Forrester. We believe it is the most effective, efficient system for our chosen market, small- to mid-tier healthcare payers serving fewer than 500,000 lives. We pride ourselves on delivering smooth implementations, so that your members and providers can go on with business as usual from the planning stage through Go-Live.

Our dedicated account management team provides efficient communications within all levels of Adaptis, including the executive management team.

Our service level agreements (SLAs) are contractual guarantees that we will meet your performance expectations.

Healthcare BPO Services

Claims Processing and Related Services

• Claims processing
• Member services
• Group administration
• Financial management
• Provider services
• Consumer directed health plan(CDHP) administration

Medical Management

• Case management
• Utilization management
• 24-hour nurse line
• Disease management

Decision Support (Analytical Reporting)

• Outcomes – HEDIS
• Predictive modeling  
• Provider profiling

Supporting Services

• Account management
• Regulatory compliance
• Help desk
• Disaster recovery/Business continuance

Adaptis Management Team

• Jim Anderson, President and Chief Executive Officer
• Jan Claesson, Chief Business Development Officer
• Mort Latta, Chief Operating Officer
• Bob Peters, Chief Financial Officer
• Sharon Gorman, Vice President, Human Resources and Corporate Administration
• Leanne Hughes-Mickel, Vice President, Business Services
• Keith Morris, Vice President, Project Management Office
• Roya Rezai, Chief Compliance Officer