Payer credentialing software

Health plans and managed care organizations automate and simplify all aspects of provider data management using symplr Payer (formerly Vistar eVIPs) software. 

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One provider data source of truth for health plans and managed care organizations

symplr Payer (formerly Vistar eVIPs) is a powerful, web-based software solution with comprehensive end-to-end functionality for integrated provider management tailored to the needs of payer organizations. 

Eliminate or reduce manual steps and reliance on paper processes for primary source verification, credentialing, contracting, network management, quality improvement, ongoing monitoring and compliance, and reporting.

Automated credentialing

Online provider initial and re-credentialing application submission/intake, rules-driven verification, and automated workflows speed credentialing time. 

Maintain compliance with regulators and accreditors such as CMS, NCQA, and The Joint Commission with continuous monitoring, PSV standards, and automated targeted verification, including DEA licenses.

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Product and plan management

Track line-of-business (LOB/Network) details, including provider IDs, date ranges, contract relationships, tax identifiers, services, panel statuses, and directory flags.

Accurately maintain the data to support claims system configuration and billing initiatives. Network management tools and reporting allow you to instantly create networks and evaluate network adequacy.

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Enterprise integration

Integration and SOA become the cornerstone for business operations and intelligence. Leverage industry data sources (e.g., CAQH, SAM.gov, QRXS, NPPES, and state boards) via automated interfaces.

Multiple data sources (clinical and claims systems data, delegated entities, and contract entities) integrate with client-specific business rules.

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Contract management

Our comprehensive contracts tool allows for streamlined end-to-end contract processing, including negotiation, generation, and automation of contracts.

Dashboard alerts/tasks and reports allow for timely processing and accurate monitoring. 

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Payer enrollment software

Simplify and expedite the enrollment process with plan mass insert functionality, automated forms population, status history tracking, alerts, and overall workflow automation for improved turnaround times. Configurable workflows reduce the chance of human error and ensure continuity.

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More tools and benefits

Explore provider self-service tools, features designed for network management and provider relations, configurable workflow automation tools, real-time dashboards, simple query/report development, and comprehensive security and auditing (HITRUST).

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