Conduent HSP Payer Suite

Conduent HSP Payer Suite is a core claims administration system for health plans and third-party administrators managing multiple lines of business. It is best suited to organizations that need claims automation, configurable workflows and enterprise integrations. Its breadth and delivery choices are strong, but it calls for a deliberate implementation decision and custom pricing.

Overview

HSP covers claims capture, scrubbing, adjudication and payment distribution, with event tracking, letter generation and compliance tools across the lifecycle. That breadth can bring core administrative work into one system rather than requiring separate tools for each stage. It is built for health-plan operations, not for a small team seeking a narrowly focused claims app.

Conduent reports 85–95% auto-adjudication and 99% financial accuracy. Those figures make automation and payment precision central to HSP’s appeal, though a plan’s results will depend on its claims mix and configuration. Conduent also says the platform supports more than 25 million members and processes 75 million claims annually, positioning it for substantial operating volume.

Key features

Workflows and claims automation

Pre-configured workflows include Medicare Advantage “MA in a Box,” alongside a rules engine, claim scrubbing, portals and reporting. These tools give operations teams a structured starting point for claims handling and plan administration; the particular value of the pre-configuration will be greatest for Medicare Advantage plans.

Data, documents and integration

De-normalized data views and document imaging, indexing and attachment storage support access to claim information and associated records. Conduent says HSP offers extensive APIs and a web service catalog for enterprise integration, a useful fit for organizations that need the claims system to connect with a broader environment. That integration emphasis is less compelling for buyers looking for a self-contained, minimal deployment.

Delivery and support

HSP is delivered via SaaS, BPaaS or on-premise, with a web-enabled experience that does not require local installs. The range gives health plans a choice between hosted, outsourced and self-managed delivery, though the best fit depends on how much operational responsibility they want to retain. Conduent says each client receives dedicated implementation and account support, an important part of a platform-level deployment.

Pricing

HSP uses paid, custom pricing. Conduent invites prospective buyers to connect for a price; there are no published plan tiers, seat limits, quotas or trial terms to compare. This makes it a procurement-led choice rather than a product a small team can readily assess against a fixed subscription budget.

The Conduent HSP Payer Suite plan is priced by contacting Conduent. Buyers should evaluate the delivery model, implementation needs and expected claims volume as part of that discussion; the published pricing does not provide a lower-cost tier or a self-service entry point.

Platforms

HSP supports API, self-hosted and web platforms. Its SaaS, BPaaS and on-premise delivery options offer more deployment flexibility than a web-only system, while the web-enabled experience avoids local installs.

Who it's for

HSP is designed for Medicaid Managed Care, Medicare Advantage, commercial, dental, vision, behavioral health and Health Exchange plans, as well as third-party administrators. It is a strong candidate for organizations that need a single core system spanning several of those lines, automation across the claims lifecycle and integration into an enterprise environment. A buyer with a narrow use case, limited implementation capacity or a need for transparent subscription pricing should look elsewhere.

Pros and cons

• Broad claims lifecycle coverage: capture through payment distribution, plus event tracking, letters and compliance tools, can consolidate core administrative work.
• Workflow and automation depth: pre-configured workflows, claim scrubbing and a rules engine support operational automation; Conduent reports 85–95% auto-adjudication.
• Multiple delivery models: SaaS, BPaaS and on-premise options accommodate different approaches to hosting and operations.
• Custom pricing and no published entry tier: buyers cannot readily compare a fixed price or start with a self-service plan.
• Enterprise-oriented scope: the breadth and implementation support suit health-plan operations better than small teams seeking a lightweight claims tool.

Alternatives

Browse the Insurance Claims Management category to compare more options. BriteCore may suit property and casualty insurers looking for a paid platform with Android, iOS, web and API access; its pricing is also contact-based and described as tied to production volumes. Choose CoverGo if a modular insurance platform with API, self-hosted and web access better matches the requirement; pricing is discussed with CoverGo alongside a demo.

Adcubum SYRIUS is another paid option with API and self-hosted access. tech11 Insurance Platform adds web access to a paid API and self-hosted offering. EIS ClaimCore is a paid alternative with API and web access. Origami Risk Claims and Duck Creek Claims are paid, web-based alternatives. Tigerlab Claims Management publishes a Starter plan at €9,600 a year, billed annually, for one market connection, three users, one jurisdiction and one currency; its Professional plan costs €36,000 a year, billed annually, and includes unlimited users.

Verdict

Conduent HSP Payer Suite is best for health plans and administrators that need broad claims lifecycle coverage, workflow automation and a choice of delivery models at enterprise scale. Its main reason to choose it is the combination of claims processing, integration options and multi-line support; its main reason to look elsewhere is the commitment involved in a large administrative platform with custom pricing and no published entry tier.