Newgen Solutions for Healthcare Payers

Become a Leader with Newgen Payer Management Solutions

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  • Attain Market

    Drive home a sustainable competitive advantage through enhanced Care Delivery services, improved productivity and low Total Cost of Ownership.

  • Create Operational

    Foster transactional efficiencies with members & providers through robust business process frameworks and smart service delivery models.

  • Ensure Transparency &

    Maintain high degree of process governance and quick operational turnarounds to stay compliant and avoid financial penalties.

Brochure: Newgen’s Health Plan and Health System Solution Offerings

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Newgen Solutions for Healthcare Payers

Complaints, Appeals and Grievances (CAG)

Complaints, Appeals and Grievances (CAG)Newgen’s Complaints, Appeals, and Grievances platform delivers robust functionality across the length and breadth of the complaints handling process. It provides a business configurable process automation and improvement framework that allows timely resolution of Appeals & Grievances received in any form – email, paper, mail, customer service, web portal, walk-ins, fax, electronic documents etc. It’s smart business rules engine prioritizes all critical transactions for intelligent case routing that reduces cycle times and increases productivity.
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Claims Repair

Claims RepairNewgen’s Claims Repair solution brings immense flexibility into the rules driven auto-adjudication process. The system simplifies complex claims processing, drives down costs and responds rapidly to the new benefits plans, provider contracting models and regulatory mandates. It combines business configurable process automation with best-practice templates for smarter claims processing.
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Mobile Medicare Enrollment

Mobile Medicare EnrollmentNewgen’s enterprise mobile application – ZapIn facilitates Mobile Medicare Enrollment via real time capture and processing of applications. By eliminating paper based transactions it provides Health Plans the ability to track every step of the process, ensuring a streamlined experience for the new enrollees. This capability minimizes the time required to enroll new members, reduces errors and saves money spent on the operational costs associated with managing paper.
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Provider Contract Management

Provider Contract Management Healthcare PayerNewgen Provider Contract Management system enables Payers to securely exchange information both within and outside of the organization; improve operational efficiencies; and provide visibility into the contract data. The Contract Management system integrates with existing information management systems to facilitate enterprise-wide collaboration, and greater accountability at department and user levels.
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CCM For Health Plans

CCMNewgen’s Customer Communication Management System: OmniOMS allows business users to access all available information to create timely, personalized and targeted communication across multiple communication channels. It enables Health Plans to engage their Members and Providers across various stages of communication by making each interaction count.
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Healthcare industry is booming across the globe. However, participants within the industry, especially Healthcare Payer organizations, must ensure compliance with a multitude of regulations to avoid potential penalties. Moreover, to remain competitive in an industry characterized by dynamic growth and complex regulations, Payer organizations need focus on meeting various challenges such as Better customer service, Compliance to state specific regulation, etc.

Newgen’s solution framework enables healthcare organizations to effectively address the challenges originating from regulatory compliance, cost control and customer satisfaction. Leading US Healthcare Payer transforms multiple processes with Newgen’s Solutions such as:

  • Claims Repair
  • Appeals & Grievances
  • Enrollment Process
  • Complaint Tracking
  • Provider Contracting