NewgenONE Platform for
Provider Credentialing and Configuration
Hyperactivate the entire process based on NCQA, state, and federal standards before automating the entry of PDM with pricing information.
Streamline provider oversight and effortlessly manage credential verification using the latest hyper automation techniques. Track expiration of documents, monitor compliance, streamline application and onboarding processes, and manage privileging and credentialing committees.
Ensure frictionless operations and improve efficiency by leveraging features, such as an automatic directory for easy access to provider information, pricing, demographics, and low-code-based smart rules that are compliant with NCQA, CMS, state regulations. Enable data-driven decision-making with advanced reporting (charts and reports) across functions (operational, investigative, etc.)
Features of Provider Configuration and Credentialing Management
Credentialing Verification
Automate the verification process for accuracy and efficiency. Receive real-time updates on verification status for timely decision-making. Integrate with the latest verification sources, including Medicaid state files, license websites, SAM.GOV, preclusion list, OIG, SSN death master, CLIA, PECOS, CAQH, NPPES, DEA, JCAHO, NPDB, and address validations
Document Management
Provide a secure repository with tracking capabilities for all provider-related documents. Upload, organize, and retrieve documents, storing them with the provider record or in groups
Return to Provider
Facilitate seamless communication by transferring questions or requests for additional information, to a provider. Leveraging the return-to-provider capability to request more information, documents, or clarification about the provided data.
Scalable Business Logic
Adapt to changing NCQA, CMS, and state rules. Use the system’s low code capability for easy adjustments
Application and Onboarding
Streamline electronic forms and workflows for faster onboarding. Enhance collaboration among stakeholders during the application process. Simplify credentialing and automate notifications
Privileging and Credentialing Committee Management
Provide access to a centralized platform for transparent committee collaboration and decision-making. Access relevant information and documentation for informed decision making
Provider Correspondence/Letters
Send correspondence and letters based on NCQA, CMS, State, or your requirements. Ensure providers receive transparent information.
Roster Automation
Transform unstructured provider rosters into standardized formats. Automate data into the credentialing and configuration workflow and then PDM, respectively
Credentialing Verification
Automate the verification process for accuracy and efficiency. Receive real-time updates on verification status for timely decision-making. Integrate with the latest verification sources, including Medicaid state files, license websites, SAM.GOV, preclusion list, OIG, SSN death master, CLIA, PECOS, CAQH, NPPES, DEA, JCAHO, NPDB, and address validations
Document Management
Provide a secure repository with tracking capabilities for all provider-related documents. Upload, organize, and retrieve documents, storing them with the provider record or in groups
Return to Provider
Facilitate seamless communication by transferring questions or requests for additional information, to a provider. Leveraging the return-to-provider capability to request more information, documents, or clarification about the provided data.
Scalable Business Logic
Adapt to changing NCQA, CMS, and state rules. Use the system’s low code capability for easy adjustments
Application and Onboarding
Streamline electronic forms and workflows for faster onboarding. Enhance collaboration among stakeholders during the application process. Simplify credentialing and automate notifications
Privileging and Credentialing Committee Management
Provide access to a centralized platform for transparent committee collaboration and decision-making. Access relevant information and documentation for informed decision making
Provider Correspondence/Letters
Send correspondence and letters based on NCQA, CMS, State, or your requirements. Ensure providers receive transparent information.
Roster Automation
Transform unstructured provider rosters into standardized formats. Automate data into the credentialing and configuration workflow and then PDM, respectively
