NewgenONE Platform for
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”.
Leverage the integrated solution to centralize providers’ demographics, credentialing, and contract data while ensuring consistency. Maintain a happy and healthy working relationship between different entities.
Utilize the solution’s built-in capabilities to validate data with third-party databases, generate lists of variances and promptly resolve issue to ensure accuracy, and receive timely notifications. Benefit from additional functionalities, including instant provider search, detailed reporting and analytics, and real-time API transfer for smooth data exchange. Furthermore, perform external validation checks to ensure adherence to the mandates posed by regulatory bodies.
Features of Provider Data Management
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 Screening via Integration Points
Create variance 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
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 Screening via Integration Points
Create variance 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
