Our Services
We want to collaborate through our amazing Services
Digital Experiences, Call Centers & BPO Operations
Netmark offers a variety of support services for Health plans and TPA’s from adjusters for ped claims to many other services as in audits etc, But our most requested services is a call center for providers and other BPO operations. We also provide a digital experience to our clients that greatly reduces their need on Call centers and other BPO services
Implementation
Health Plans run a complex business. From MLRs, to regulators to SOX to member retention and the multitudes of specifically tailored plans that health plans have to offer to its commercial clients and challenges that are integral to Federal and State sponsored plans. Netmark provides a simplistic agile trained team of developers, configurators, SMEs and adjusters on a hybrid platform to take over the burden of a forklift change of adjudication software.
Data-Driven Solutions
Trust in God…the rest bring data. Health Plans are relying more and more on data to make decisions on configurations, Provider contracts and quality ratings. Netmark has a robust data analytics team to support all kinds of data slicing and dicing to extract decision making detail. Our most used offering is the dashboard where we can pull data from various Data warehouses and provide a snapshot into the daily or hourly health of a health plan as in no of claims received, processed, aging, the top providers etc.
Auto Adjudication of Claims
Adjudication is the raison d'etre of all health plans. Adjudication ensures prompt payments to Providers. Auto adjudication helps automate these payments and makes the healthcare ecosystem into a well oiled machine. Netmark’s team of configurators and Subject Matter Experts help from gathering the right requirements to configuring the current system to suit the new needs of the health plan. The Netmark team manages the initial configuration of the Provider, Member and claim streams as well as work to create a real time Data Warehouse for data consumption by other ancillary services to the plan as in Print or Prior authorizations or member portals etc. Netmark takes charge of the adjudication platform as would the operations of the health plan and continues to tweak the Auto adjudication rate after go-live and after every year when the benefit configurations change and work as the BPO to handle pends and PDRs.
