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For Payer Organizations | symplr Payer

Automate and optimize provider data management

Request a demo

For Payer Organizations | symplr Payer

Automate and optimize provider data management

Request a demo

We help you navigate the complexities of managing provider data

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Ensure competent care for member populations

Meeting contract obligations means setting and adjusting the providers in-network—and determining their qualifications. symplr Payer helps you save on costs while delivering the highest-quality care to enrollees.
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Maintain complete credentialing compliance

You can’t fulfill your mission to provide competent care without maintaining compliance with regulators and accreditors, such as CMS and NCQA. symplr Payer provides continuous monitoring for verification and credentialing.
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Reinforce claims and billing initiatives

With symplr Payer, be assured your financials are precisely managed: Track line-of-business and network details, including provider IDs, date ranges, contract relationships, tax identifiers, services, panel statuses, and directory flags.

Rely on one powerful provider-data source of truth

Integrated provider management, tailored for payers

symplr Payer automates credentialing, provider relations, and contracting workflows while acting as a single source of truth for provider data management. Our solution provides a comprehensive experience for integrated provider data management tailored to the needs of payer organizations.

symplr Payer enhances your health plan or managed care organization’s compliance and efficiency, enabling you to provide adequate and competent care for member populations. We are the only cloud-based healthcare provider management solution to achieve HITRUST CSF Certification. Simplify and expedite enrollments with plan mass insert functionality, automated forms population, status history tracking, alerts, and overall workflow automation for improved turnaround times. Configurable workflows reduce human error and ensure continuity.

 

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Features designed for network management and provider relations

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Streamline contract processing

Our comprehensive contracts tool allows for streamlined end-to-end contract processing, including negotiation, generation, and automation of contracts.
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Instantly create networks and evaluate network adequacy

Accurately maintain the data to support claims system configuration and billing initiatives, with network management tools and reporting.
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Integrate with client-specific business rules

Automatically connect with industry sources (e.g., CAQH, SAM.gov, QRXS, NPPES, state boards), and align with client-specific clinical and claims systems data.

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