Provider Contract Management

Expedite contracting process, minimize financial risk and reduce administration costs

Request Information

  • Simplify
    Contract Management

    Get rid of filing cabinets and digitally centralize and manage all types of contracts and associated documents.

  • Expedite
    Document Workflow

    Save time during negotiations with providers through secure document sharing and streamlined approval process.

  • Reduce
    Contracting Risk

    Ensure that you are working with valid business partners through end-to-end process visibility and performance monitoring.

Flyer: Simplifying Provider Contracting process with Newgen

Download Flyer

Newgen Provider Contract Manager

  • Newgen Provider Contract Manager helps Health Plans develop a centralized and fully automated system to process and manage contracts and all subsequent requests. Built on Newgen’s advanced Enterprise Content Management (ECM) and Business Process Management (BPM) systems, it delivers speed and accuracy across the contract lifecycle.

    The system creates a centralized repository of contract information and provides business user with role-based access to sensitive contract data and documents. It then orchestrates this information across departments using an advanced workflow engine that automates critical business processes.

Wellcare“Newgen has partnered with Wellcare for over 8 years and has successfully automated mission critical processes such as Provider Contract Configuration and Credentialing for us. The quantifiable increases in productivity speak for themselves – The turnaround time for the provider contracting process has gone down by 35%, operational costs have reduced by 40% and compliance has increased by 95%.”

- Renee Santana, Director – Configuration, Wellcare

  • Newgen Provider Contract Manager: Contract Lifecycle Management

  • Newgen Provider Contract Manager: Credentialing

  • Newgen Provider Contract Manager: Configuration

Contract Creation and Archival

Provider Contract Management Solution

Sales executives with minimal legal experience need to be empowered with smart tools to drive value driven contracts with closely monitored SLAs. Newgen Provider Contract Manager provides an automated, self-service environment for business users with minimal contract experience to draft agreements. Guided authoring tools ensure consistency and accuracy, shortening the negotiation cycles and minimizing legal risks. All negotiations and re-negotiations are taken care of by the system through real-time stakeholder collaboration and robust document versioning.

Feature Highlights:

  • Standard templates with pre-defined language, clauses and contract terms
  • Centralized document repository and extensive reporting dashboards
  • Advanced search capability for retrieving the contracts by various department such as claims and legal teams
  • Robust document versioning and provision for seamless stakeholder collaboration

Provider Credentialing

Provider Credentialing

Credentialing for all providers is a key compliance imperative. This can however be complex and time-consuming due to the multi-level checks prescribed by various regulatory bodies. Newgen Provider Contract Manager comes with an advanced workflow that manages the provider credentialing in a sequential and organized manner. Cases are auto-routed to resources when the system finds a match between the user profiles and the applicable state laws. Users can work on an pre-configured, intuitive checklist that we have built using our rich domain knowledge, to make sure there are no slip-ups.

Feature Highlights:

  • Integration with Council for Affordable Quality Healthcare (CAQH) for pulling the Provider data and documents
  • Rule defined work progression and auto-routing of cases to various work queues
  • Pre-configured, intuitive checklist and a highly configurable GUI for business users to guide them to work in a sequential manner
  • Highly regulated, role based access of credentialing documents to users

Provider Configuration

Provider Contract Management Solution

Configuration is a complex process which requires careful aggregation and auditing of provider information that includes their demographic, institutional, professional and financial details. It also involves extensive documentation and data entry work which can result in numerous operational errors. Newgen Provider Contract Manager streamlines the entire configuration process, from Case Initiation to Provider Loading and generation of correspondence letters. All approvals and rejections are managed through a structured and automated review process.

Feature Highlights:

  • Tight Integration with CRM and HMS for data exchange and a ‘First Time Right’ auto configuration of provider
  • Auto assignment of work, based on the state specific skill sets of resources and other parameters
  • Parallel and sequential routing of work, based on the Request Type
  • Smart exceptions & approvals management with auto-email triggers and instant notifications
  • Streamlined processes of multiple request types such as address change, provider termination, renewals, addition of new providers to existing contracts etc.

Provider Communication

Provider Communication

Providers need to be constantly apprised of the changing contract dynamics. They must also be reminded of any missing information to complete the provider configuration. Newgen Provider Contract Manager ensures timely and automated provider communications through event based triggers. For instance, in case the provider is terminated from the already existing contract, the members are re-assigned to another Provider and both parties are informed of the same. Similarly, on completion of the provider configuration, welcome letters are generated without any delay due to manual handling of work.

Feature Highlights:

  • Automated provider communication including issuance of Welcome Letters to Providers with their effective loading dates in the HMS
  • Notifications, alerts, follow-ups to Providers & Sales executives in case of exceptions/discrepancies
  • Ability to manage bulk amendments

Reporting and Monitoring

Reporting and Monitoring

Contracting process needs to be mapped end-to-end to ensure compliance adherence and resource productivity. Newgen Provider Contract Manager is built on a world class BPM platform that provide advanced tools for real-time process monitoring and performance management. Business users have a unified dashboard where they can view various aspects across the contracting lifecycle.

Feature Highlights:

  • Comprehensive operational, productivity and compliance dashboard along with extensive reports

Request A Demo of Provider Contract Management Software

New care delivery models, complex regulations and narrowing provider networks have altered the Provider Contract Management Process significantly. An oversight at any stage of the contract lifecycle can result in non-compliance, financial penalties and an unhappy provider network, impacting the overall quality of member care. Health Plans require tools to create and manage value-based contracts with the providers so they can ensure transparency and uninterrupted care delivery to their members.

Newgen Provider Contract Manager helps Health Plans develop a centralized and fully automated system to process and manage contracts and all subsequent requests. Built on Newgen’s advanced Enterprise Content Management (ECM) and Business Process Management (BPM) systems, it delivers speed and accuracy across the contract lifecycle. Its benefits are:

  • Contract Creation and Archival
  • Provider Configuration, Provider Credentialing & Provider Communication
  • Reporting and Monitoring