We’re changing the game when it comes to buying and selling healthcare services.
We’re changing the game when it comes to buying and selling healthcare services.
Costs vary considerably for the same diagnosis or healthcare procedure. Understanding and efficiently navigating these price variations can help Payers drive growth and achieve greater competitive advantage.
How can Payers resolve disparate costs, while at the same time, ensure members have access to Provider Networks that offer the best possible care?
We can help. The insights we identify through our robust analytics Platform provide Payers with a clear picture of past and current healthcare purchasing performance. We then present an unbiased view of the Provider Networks and healthcare services that bring the most value and best fit the needs of a particular population of members.
Our data-driven network optimization equips Payers with a deep understanding of plan performance, allowing them to evaluate and select Provider Networks that best align with their business.
We turn network selection into a strength for your organization
Costs vary considerably for the same diagnosis or healthcare procedure. Understanding and efficiently navigating these price variations can help Payers drive growth and achieve greater competitive advantage.
How can Payers resolve disparate costs, while at the same time, ensure members have access to Provider Networks that offer the best possible care?
We can help. The insights we identify through our robust analytics Platform provide Payers with a clear picture of past and current healthcare purchasing performance. We then present an unbiased view of the Provider Networks and healthcare services that bring the most value and best fit the needs of a particular population of members.
Our data-driven network optimization equips Payers with a deep understanding of plan performance, allowing them to evaluate and select Provider Networks that best align with their business.
We turn network selection into a strength for your organization
Once Payers select the most suitable Provider Networks, they connect through our first-of-its-kind proprietary SaaS Platform. Our secure, cloud-based Platform gives Payers easy access to multiple Provider Networks from a single integration point.
EDI/API Connectivity
Our SaaS Platform offers cutting edge interoperability with the ability to leverage FHIR standards, to transform and route enrollment, claims, and other administrative transactions to and from the chosen Provider Network(s).
Data Management & Translation
Easily adapting to existing data formats and protocols, our Platform allows Payers and Provider Networks to communicate without interruption.
When Payers optimize and connect, they can leverage improved Provider access, lower healthcare costs, achieve better margins, increase operational efficiencies, and foster membership growth.
Our solution allows Provider Networks to grow their businesses by identifying potential cost saving opportunities and reaching new health plan members. Our Platform streamlines interoperability to those plans, easing technical burdens and ensuring accurate, secure interchange of data.
State and federal regulations continue to evolve to protect consumers from surprise medical costs and to create increased price transparency. To remain competitive and compliant, Payers and Provider Networks must understand and navigate regulatory requirements, e.g., Price Transparency, the Federal No Surprises Act, and health information technology exchange standards from ONC.
As we stand with customers to optimize, connect, and grow, Payers and Provider Networks benefit from our technology Platform and in-depth experience in healthcare and regulatory environments. We help you stay a step ahead of complex and changing healthcare rules and requirements.
