TriZetto
Accelerate payment while decreasing administrative burdens. With 8,000+ payer connections and longstanding partnerships with 650+ practice management vendors, our claims management solutions can result in fewer pending claims and less manual intervention. Quickly and accurately transmit professional, institutional, dental, workers compensation claims and more for fast reimbursement. Meet the shift to healthcare consumerism head on by providing a straightforward and seamless financial experience. Our patient engagement solutions empower you to have informed conversations about eligibility and financial responsibility while reducing hurdles that may impact patient outcomes.
Learn more
CAQH
CORE brings the industry together to accelerate automation and develop business processes that streamline healthcare for patients, providers and health plans. Drawing on the industry's most trusted source of provider and member data, CAQH enables healthcare organizations to reduce costs, improve payment integrity and transform business processes. In the ever-evolving landscape of healthcare, continuous improvements in payment and claims processing systems are vital. The nation’s providers and health plans trust CAQH to collect and manage professional information, verify primary sources, and monitor for sanctions. The result, is streamlined administration, greater regulatory compliance, and better provider data management.
Learn more
Kyruus ProviderMatch
Industry-leading provider search, scheduling, and data management solutions that help health systems match patients with the right providers and optimize patient access enterprise-wide. Our provider search and scheduling solutions—built on the KyruusOne® provider data management platform—enable health systems to optimize patient-provider matching; boost patient acquisition and conversion; and deliver a consistent patient experience across key points of access. Differentiate your digital presence with a modern patient access experience that enables people to find the right care options for their needs and book easily online. Connect consumers with the right providers through your call center by empowering agents with the technology they need to match and schedule patients more precisely. Boost patient retention by giving providers and staff new visibility into the providers in your network and enabling patients to leave their appointment with the next one booked.
Learn more
symplr Payer
Save on costs, eliminate data silos, and deliver better outcomes for your members with a unified, automated provider data solution. symplr Payer provides a single source of truth for provider data that is consistently reconciled and validated against primary sources. It improves data quality, access, and transparency. Further, it eliminates duplicate requests for information, reducing provider frustration. Using symplr Payer as the enterprise-wide hub for provider data, payers can feed timely, accurate information to other downstream systems. Our highly configurable, end-to-end provider data management solution manages all pre-contract and renewal contract negotiations. Standardize and streamline your contracting processes, while capturing contract details such as sentinel events, trigger dates, configuration efforts, process steps, fee schedule info, and more. symplr Payer’s unique design allows your organization to consolidate contracting and credentialing.
Learn more