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Orchestrating the End-to-end Provider Lifecycle Across Onboarding, Credentialing, and Ongoing Compliance
Manage the full provider lifecycle from initial application through credentialing, contracting, and ongoing monitoring. Reduce onboarding time with smarter verification, intelligent document management, and auditbale workflows for NCQA compliance.
“Implementing Newgen’s Provider Lifecycle Management Solution enabled us to achieve a six-month return on investment, reduce onboarding turnaround time by 84%, gain visibility into our vital provider data, and enhance operational efficiency.”
– Head of Payer Strategy, A Leading Health Plan in the US
Provider Lifecycle Management: Buy All-in-one Pack or Choose an Individual Solution
Learn What Newgen’s Provider Lifecycle Management Solution Can Do for You
Contract and Document Summarization with Marvin AI
Summarize contracts with the click of a button using Marvin. Optimize and streamline the contracting, credentialing, and configuration process by asking questions and receiving suggestions. All questions and responses are recorded for future reference
Value-based Contracting & Non-Standard Risk Scoring in Contracting with AI
Enable value-based contracting and non-standard risk scoring with AI. Analyze complex contracts using built-in risk scoring algorithms, encompassing a combination of network access, rates, provider history scorecard, quality, provider profile, and more
Chatbot on Provider Portal with Marvin AI
Allow providers to ask questions, get directed to call center, learn more about the provider portal, and chat with a provider relations representative through Marvin AI
Value-based Contract Creation
Create complex value-based contracts that consider quality, efficiency, error rate, compliant, Stars/HEDIS, financial (RCM) and more. Achieve higher quality care and better health outcomes for members
Improved Star Rating and State Incentives
Achieve favorable ratings with three or more stars, encouraging bonus payments as incentives for delivering quality care and enhancing patient satisfaction. Ensure consistency and accuracy in ratings, improving your goodwill and trust among providers
Better HEDIS and NCQA Results
Get financial rewards for exceeding score thresholds in HEDIS metrics and encourage initiatives for better health outcomes. Improve HEDIS metrics to secure better incentives for providers and insurers, promoting smooth collaboration and alignment towards shared objectives. Meet all the required NCQA standards for onboarding and maintaining the provider’s data
Market Scalability
Operate efficiently across states and products through a unified platform to minimize administrative complexities, enhance market scalability. Incorporate multiple product ingredients and apply smart rules to adopt to changing market demands and regulations, facilitating sustained growth through market expansion
Explore Other Solutions for the Payer-Provider Journey
Claims Automation
Streamline claims with an AI-driven, low-code automation process.
Provider Relations and Complaints
Enhance provider relationships while streamlining communications and driving a collaborative environment.
SIU & FWA Case Management
Detect and address fraud while enhancing efficiency and ensuring compliance.
See How Much You Can Save with Newgen’s PLM Solution
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Frequently Asked Questions related to Provider Lifecycle Management (PLM)
Provider Lifecycle Management (PLM) software is an end-to-end healthcare solution that automates the provider journey, including onboarding, credentialing, contracting, provider data management, compliance, and self-service.
Newgen PLM leverages AI, machine learning, and robotic process automation (RPA) to reduce manual work, accelerate processes, and ensure compliance for health plans and payers.
Health plans and payers need PLM solutions to eliminate manual processes, reduce administrative costs, improve provider directory accuracy, and stay compliant with CMS, NCQA, URAC, and state regulations. With AI-driven data validation and monitoring, PLM also improves accuracy and reduces compliance risks.
PLM integrates with claims platforms, provider directories, credentialing databases, CRMs, and regulatory data sources (CAQH, NPPES, OIG, SAM.gov, DEA, CLIA). AI-powered connectors and RPA bots enable automation even when APIs are unavailable.
Yes. PLM is modular and flexible, if a payer already has a credentialing engine, contracting repository, or data warehouse, Newgen’s PLM can seamlessly integrate through APIs, file loads, or workflow triggers. AI-enabled mapping ensures consistency across systems without disrupting legacy investments.
PLM can be deployed on-premises, in private or public cloud environments (AWS, Azure, GCP), or through a Newgen-hosted model.
Accurate, AI-validated provider data ensures compliant directories, helps members find in-network doctors quickly, reduces frustration, and supports better CMS Star ratings.
Newgen provides an interactive tool to estimate cost savings, compliance improvements, and efficiency gains from PLM. Try the Newgen PLM ROI Calculator to see potential benefits for your organization.
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