Intelligent Health MarketplaceHealth Market Partner Directory
Explore the range of Health Market Partners servings Payers on the MacroHealth Intelligent ExchangeTM marketplace. Identify categories to optimize your healthcare spending or enhance your offerings, and learn about the Health Market Partners in each optimization.
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Fee Negotiation
NSA/QPA
Out of Network
Payment Integrity
Provider Contract Repricing/Contract Management
Provider Network
Specialty PBM
6 Degrees Health
6 Degrees Health is a healthcare cost containment company focused on superior results and customer experience. We use clinical expertise and technology to ensure fair reimbursements and improve payment accuracy.
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Fee Negotiation
NSA/QPA
Out of Network
Payment Integrity
Provider Contract Repricing/Contract Management
Provider Network
Specialty PBM
CERIS
As a leader in claim reviews, CERIS uses clinical expertise to ensure accuracy in healthcare payments. With over 30 years of experience in Prepay, its universal chargemaster contains items from over 97% of the nation’s hospitals, ensuring accuracy and an objective claim review.
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Fee Negotiation
NSA/QPA
Out of Network
Payment Integrity
Provider Contract Repricing/Contract Management
Provider Network
Specialty PBM
ClearHealth Strategies
ClearHealth Strategies offers top technology and services for reference-based pricing, out-of-network, supplemental network and surprise billing programs with a turnkey approach to manage profile building, claim pricing, balance billing, hold harmless, and arbitration (IDR) processes.
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Fee Negotiation
NSA/QPA
Out of Network
Payment Integrity
Provider Contract Repricing/Contract Management
Provider Network
Specialty PBM
CMSPricer
CMSPricer is a Medicare pricing/editing and Contract Manager technology solutions company. Our Contract Manager solution easily loads all network contracts and processes all claim types based on both Medicare and non-Medicare fee schedules.
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Fee Negotiation
NSA/QPA
Out of Network
Payment Integrity
Provider Contract Repricing/Contract Management
Provider Network
Specialty PBM
FairCost
FairCost helps control the cost of out-of-network medical claims. Our services cover the full spectrum of out-of-network claims. Learn more about our products: FairCost QPA Assist™ and FairCost Optimizer™.
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Fee Negotiation
NSA/QPA
Out of Network
Payment Integrity
Provider Contract Repricing/Contract Management
Provider Network
Specialty PBM
First Health
First Health® provides national and regional Preferred Provider Organization (PPO) network access and other cost containment programs to help our clients manage employee benefit plans. For example, the First Health Network is one of the largest directly contracted networks.
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Fee Negotiation
NSA/QPA
Out of Network
Payment Integrity
Provider Contract Repricing/Contract Management
Provider Network
Specialty PBM
Networks By Design
Networks By Design is the leading California client-customized PPO/EPO network company. We have the network development expertise and treatment data information to design client specific Group Health medical networks. These client- tailored networks meet the needs of each individual employer client. We are not the typical “large commodity PPO network” using outdated demographic information and covering excessive geography. We believe a one-size-network does not fit all!
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Fee Negotiation
NSA/QPA
Out of Network
Payment Integrity
Provider Contract Repricing/Contract Management
Provider Network
Specialty PBM
NovaNet
NovaNet is a PPO delivering network coverage with a distinct perspective, and it is not owned by physicians, hospitals or insurance carriers. This allows NovaNet to creatively collaborate with its clients to deliver the most effective products and services for members.
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Fee Negotiation
NSA/QPA
Out of Network
Payment Integrity
Provider Contract Repricing/Contract Management
Provider Network
Specialty PBM
Plotkin Health
Plotkin Health is a medical cost containment company serving over 50 national & international health insurers. Specializing in all facets of medical loss mitigation, Plotkin Health is your trusted partner in fair, ethical and simple healthcare claim resolution.
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