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Seamlessly Manage the Full Provider Data Lifecycle

Automated. Integrated. Simplified.

symplr's Provider Data Management software is a robust workflow solution that automates and streamlines all aspects of Provider Data Management for health plans and managed care organizations, including credentialing, re-credentialing, contracting, network management, quality improvement, ongoing monitoring & compliance, robust reporting, integration and more.

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Features

symplr's Provider Data Management software offers a powerful web-based solution with comprehensive end-to-end functionality for integrated provider management. 

Automated Credentialing

Simplified Contracting

 Automated Payer Enrollment

Self-Service Tools to
Support the Provider Community 

Comprehensive Security and Auditing, HITRUST Certified

Network Management and Provider Relations

Configurable
Workflow
Automation

Real-Time
Dashboards to
Drive Productivity

 

 

Simple Query/Report Development 

Standard and Customized Inbound/Outbound System Interfaces

One Single Source-of-Truth
for All Provider Data

Automated Credentialing

symplr provides the highest level of provider credentialing functionality. Online provider initial and re-credentialing application submission and intake, rules-driven primary source verification (PSV), and automated workflows will shorten your cycle time. 

Stay in compliance with regulatory agencies such as Centers for Medicare & Medicaid Services (CMS), National Committee for Quality Assurance (NCQA), Utilization Review Accreditation Committee (URAC), and The Joint Commission (TJC) with continuous monitoring, PSV standards, and automated targeted verification, including DEA licenses.

Web-based tools for medical director review simplifies committee preparation and approvals.

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Automated Credentialing Software

Product and Plan  Management

Track lines-of-business (LOBs/Network) details including providers ID's, date ranges, contract relationships, tax identifiers, services, panel statuses, and directory flags.

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

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Product and Plan Management

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Contract Management

Our comprehensive Contract Management 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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Contract Management

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Enterprise
Integration

With symplr, integration and SOA become the cornerstone for business operations and intelligence.

Leverage industry data sources such as CAQH, SAM.gov, QRXS, NPPES, and various state boards via automated interfaces.

Multiple data sources such as clinical and claims systems data, delegated entities, and contract entities will be integrated with client-specific business rules and logic services layer.

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Enterprise Integration Options
 

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Quality Issue Manager

Connect incident management, patient event reporting, provider performance management, and peer review with Quality Issue Manager, a web-based workflow and reporting solution that tracks any grievance or complaint from inception to outcome.

Configurable to include your own policies, procedures, bylaws, and severity levels, this module helps you meets organizational goals and comply with NCQA standards, with complete data security. It is the only product that provides online quality issue reporting and a configurable performance management system with peer review workflow by user type

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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.

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Payer Enrollment Software

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What Our Clients Say About symplr

symplr Provider Management Platform

“It is without reservation that I recommend symplr. From initial planning, testing and implementation through updates, upgrades, and new products and services the symplr team has been a responsive and knowledgeable collection of professionals.”


Kenneth Payne Medical Mutual of Ohio

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