“With newer trends and developments in care delivery models, regulations as well as provider networks, provider contract management as a process is changing significantly,” said Anand Raman, VP – Sales and Marketing, Newgen Software Inc.
“Our comprehensive solution empowers Health Plans to manage end-to-end delivery of services in a cost-effective manner and transforms Provider Contracting process digitally from being an operational bottleneck to a business enabler,” he added.
Storing provider contracts on paper and managing them manually make the process of updating contracts, variance analysis and compliance audits time-consuming and erroneous. Newgen’s solution manages end-to-end contract lifecycle and performs activities like contract creation, authoring, amendment, renewal, reconsideration, termination, servicing and configuration. Health Plans can get orchestrated information across departments using an advanced workflow engine that automates critical business processes.
The solution encompasses enlisted features:
- Legacy Contracts Migration: Allows easy transfer of legacy contracts into the system
- Contracting: Helps create, author, renew, amend, reconsider, terminate, redline and accept or reject contracts
- Workflow capability: Routes a case to different stakeholders based on defined business rules, and upon approval, the solution automatically updates the information in the core claim system
- Mass Amendment: Facilitates updating of existing contracts on one go
- Alternate Language: Helps in creating pre-approved alternate languages (Preferred, Acceptable, Discouraged, Unacceptable.) in the system and use during authoring and negotiation
- Duplicate Provider Check: Eliminates duplicity by checking all the incoming provider applications
- Provider Servicing and Configuration Module: Helps intake provider requests via multiple channels and update core systems
- Integration with:
- Adobe Sign to digitally sign the contract
- CAQH and Credentialing Systems to verify the credentials of providers
- Core Claim Systems (Facets, Excyles) to exchange data across systems
- Provider Portal to intake provider application via portal
About Newgen Software Inc.
Newgen Software Inc., is a provider of Business Process Management (BPM), Enterprise Content Management (ECM) and Customer Communication Management (CCM) platforms with large, mission-critical solutions deployed at world’s leading Banks, Insurance firms, Healthcare Organizations, Governments, BPO’s & Telecom Companies.