AI-Driven Provider Data Management Software

Digital. Dynamic. Dependable.

Maintain a well-organized directory of providers within the network by utilizing an AI-driven, Provider Data Management Solution, built on NewgenONE—a unified digital transformation platform. Deliver transformed member experience and ensure compliance adherence with marketing materials and the “No Surprises Act.

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“Newgen’s data management solution enabled us to maintain a well-organized provider directory while drastically minimizing errors and strengthening relationship with our providers. The real-time data validation and reporting features have made compliance effortless.”

– CIO, Leading Healthcare Payer

Learn What Newgen Health Solutions for Provider Data Management Can Do for You

Robust Integration

Integrate with other applications and claims systems. Validate data against key data sources, such as Medicaid state files, license websites, SAM.GOV, preclusion lists, OIG, SSN death master, CLIA, PECOS, CAQH, NPPES, DEA, JCAHO, NPDB, and address validations.

Variance & Reconciliation Screening

Create variance and reconciliation reports for providers failing key integration checks. Initiate cases in credentialing and configuration workflows for review by your case workers.

Unified Data Management

Access centralized provider demographics, credentials, and contracts for consistency. Maintain a single source for records management.

Entity Relationship Maintenance

Ensure easy and hassle-free management of relationships between different providers. Enhance understanding of provider networks and affiliations through clear presentation.

Flexible Provider Hierarchy and Structure

Deploy a low-code, flexible structure adaptable to your existing or future structure plans. Meet existing NCQA, CMS, and state guidelines while accommodating additional field growth during expansion in future

Provider Update History

Access complete provider histories with a single search. View all provider documentation in one place. Review notes and completed credentialing and configuration cases for detailed analysis

Provider Lifecycle Management: Buy All-in-one Pack or Choose an Individual Solution

Provider Data Management

Maintain a well-organized directory of providers within the network for superior member experience and ensure compliance for marketing materials and the “No Suprises Act”

Provider Credentialing

Hyperautomate credentialing verification and pricing process in compliance with NCQA, CMS, and state and federal standards

Provider Contracting

Streamline end-to-end contracting process, from single case agreements to contracts and amendments to value-based contracts—ensuring a robust network that drives optimal care outcomes

Self-service Portal

Empower your providers to submit, update, and view their information on a transparent and innovative portal

Explore Other Solutions for the Payer-Provider Journey

Provider Lifecycle Management

Stay current, competitive, and expansion-ready in contracting, credentialing, configuration, provider data management (PDM), and provider self-service.