Case Study

Streamlining Provider Contracting with Newgen's Provider Network Management

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A leading Health Plan, with a network that spans across the United States, used Newgen’s Provider Network Management to streamline its provider contracting process. The client serves approximately 3.8 million members and partners with over 90,000 physicians across the US. They offer Medicaid, Medicare Advantage & Medicare Prescription Drug Plans.

Key Challenges Faced by the Health Plan

Manually managing a high volume of paper-based contracts was posing operational challenges to the client, leading to increased provider onboarding time and compliance issues.

  • Manual Hand-offs: Loss of data and documents during hand-offs between multiple departments
  • Process Visibility: Low visibility into pending cases and cases in progress
  • Content Management: Inability to monitor changes/ amendments in contracts
  • Lack of Security: No centralized repository for archival of documents and PHI data
  • Credentialing: Challenge in adhering to guidelines due to delays in provider verification
  • Collaboration: Longer review and negotiation cycles due to low collaboration across stakeholders
  • High Costs: High administrative costs such as shipping, printing, and storage

Streamlining Provider Contracting

With Newgen on board, the client simplified its provider contracting process. The implementation of Newgen Provider Contract Management solution based on its Intelligent Business Process Management platform, enabled them to gain operational efficiencies and enhance provider on-boarding experience.