98% Improvement in CMS Compliance     |     90% Reduction in Error Rate     |     50% Increase in Report Delivery Levels    |    50% Enhancement in Adherence to Due Dates     |     60% Improvement in External Agency Collaboration     |     75% Rise in Data Validation     |     98% Improvement in CMS Compliance     |     90% Reduction in Error Rate     |     50% Increase in Report Delivery Levels    |    50% Enhancement in Adherence to Due Dates     |     60% Improvement in External Agency Collaboration     |     75% Rise in Data Validation     |     98% Improvement in CMS Compliance     |     90% Reduction in Error Rate     |     50% Increase in Report Delivery Levels    |    50% Enhancement in Adherence to Due Dates     |     60% Improvement in External Agency Collaboration     |     75% Rise in Data Validation     |     98% Improvement in CMS Compliance     |     90% Reduction in Error Rate     |     50% Increase in Report Delivery Levels    |    50% Enhancement in Adherence to Due Dates     |     60% Improvement in External Agency Collaboration     |     75% Rise in Data Validation     |     98% Improvement in CMS Compliance     |     90% Reduction in Error Rate     |     50% Increase in Report Delivery Levels    |    50% Enhancement in Adherence to Due Dates     |     60% Improvement in External Agency Collaboration     |     75% Rise in Data Validation     |     98% Improvement in CMS Compliance     |     90% Reduction in Error Rate     |     50% Increase in Report Delivery Levels    |    50% Enhancement in Adherence to Due Dates     |     60% Improvement in External Agency Collaboration     |     75% Rise in Data Validation     |    

“With Newgen’s solutions, we achieved a 154% increase in case processing efficiency that helped us process 5 million cases and save $20 million annually. Beyond the numbers, the real value was in the time saved and the reduction in errors, which directly impacted our bottom line.”

CTO, A Fortune 500 Healthcare Payer in the US

Built for Payers. Designed for Members.

Leverage our Complaints, Appeals, and Grievances Suite to build trust and loyalty with a member-first approach. 

Go All-in on Interoperability with our Complete Product Pack or Choose Individual Modules

Member & Provider Appeals

Simplify the appeals process for members and providers with our solution. Leverage intelligent automation and end-to-end case management to handle appeals efficiently, ensuring fairness, accuracy, and compliance with regulatory timelines.

Learn More >

External Review

Provide members with a transparent and seamless external review process. Automate submissions, manage communication with external agencies, and ensure timely, equitable resolutions for high-stakes appeals with our solution.

Learn More >

Grievance & Complaints

Ensure every member’s voice is heard and resolved effectively. Automate the intake, categorization, and resolution of grievances and complaints while empowering payers to respond swiftly while maintaining a transparent audit trail for compliance.

Learn More >

CTM

Leverage CTM module, interface with HPMS. Navigate Medicare-related complaints effortlessly. Track, document, and resolve cases seamlessly with our CTM solution, ensuring compliance with CMS guidelines, minimizing risk, and building member trust.

Learn More >

Member Service Inquiries

Manage inquiries efficiently by leveraging the solution—built on NewgenONE—an AI/ML-driven, low code platform. Streamline request handling for information, assistance, or clarification from patients, providers, and stakeholders.

Learn More >

Provider Disputes Management

Resolve provider claims seamlessly using the solution, built on NewgenONE—an AI/ML-driven, low-code platform. Simplify dispute management through automated workflows, enhanced data, and compliance checks.

Learn More >

Member & Provider Appeals

Simplify the appeals process for members and providers with our solution. Leverage intelligent automation and end-to-end case management to handle appeals efficiently, ensuring fairness, accuracy, and compliance with regulatory timelines.

Learn More >

External Review

Provide members with a transparent and seamless external review process. Automate submissions, manage communication with external agencies, and ensure timely, equitable resolutions for high-stakes appeals with our solution.

Learn More >

Grievance & Complaints

Ensure every member’s voice is heard and resolved effectively. Automate the intake, categorization, and resolution of grievances and complaints while empowering payers to respond swiftly while maintaining a transparent audit trail for compliance.

Learn More >

CTM

Leverage CTM module, interface with HPMS. Navigate Medicare-related complaints effortlessly. Track, document, and resolve cases seamlessly with our CTM solution, ensuring compliance with CMS guidelines, minimizing risk, and building member trust.

Learn More >

Member Service Inquiries

Manage inquiries efficiently by leveraging the solution—built on NewgenONE—an AI/ML-driven, low code platform. Streamline request handling for information, assistance, or clarification from patients, providers, and stakeholders.

Learn More >

Provider Disputes Management

Resolve provider claims seamlessly using the solution, built on NewgenONE—an AI/ML-driven, low-code platform. Simplify dispute management through automated workflows, enhanced data, and compliance checks.

Learn More >
Low Code Solutions with Accelerator Products

Newgen’s accelerator products are interconnected components designed to fast-track your development projects. With extensive R&D already invested in the foundational elements, these products serve as a ready-to-use base. Developers—yours or ours—can customize them to meet your unique requirements. Together, we deliver a tailored solution quickly, ensuring the final product aligns seamlessly with your timeline and goals.

Key Benefits

  • Leverage Ready-to-use, Highly Configured Solutions: Access solutions pre-configured with hundreds or thousands of business rules, allowing you to streamline processes from day one
  • Reduce Implementation Time: Minimize integration and customization time for faster deployment, getting your systems up and running with minimal disruption
  • Prepare for the Future with Scalable Technologies: Adopt scalable, modular solutions that address current challenges and evolve with your health plan’s future needs
  • Drive Innovation and Member Experience: Benefit from continuous innovation to provide members with the best possible experience while maintaining efficiency and compliance
Healthcare Contract Management Solution
Value-added Products for the Member Journey

Newgen Delivers Fast Time-to-value

Forrester analyzed the Total Economic Impact™ of Newgen and its low code and cloud-based platform

Read The Report

371 %

return on investment

$29 Mn+

value generated

Months

payback

Find Your Winning Strategy with Newgen

Request a demo to explore our solutions for the Payer-Member Journey.

Request a Demo

Got Questions?

Enter your information, and a Newgen representative will be in touch shortly.

icon-angle icon-bars icon-times