Customized Solutions for Government Healthcare Plans

Customized government healthcare networks and payment integrity programs

Value we deliver

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  • Healthcare networks provide access to high quality healthcare providers for the most vulnerable populations
  • Healthcare payment integrity resolves waste and abuse either after or before you pay, so you spend less time and money reclaiming overpayments

Programs we serve

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  • Medicare and Medicare Advantage
  • Medicaid and CHIP
  • Federal and State Agencies

Best in class network-based services for Medicare Advantage plans

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For 40 years, MultiPlan has made it a priority to cultivate strong provider relationships, resulting in long-lasting partnerships consisting of more than a million providers. 

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Network Services for Medicare Advantage Plans

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Whether you’re struggling with speed to market, meeting CMS adequacy requirements, credentialing providers or need filing support, MultiPlan can help. We have direct contracts with more than 1 million providers, most of which are credentialed to National Committee for Quality Assurance (NCQA) standards. These providers represent all provider types and specialties and are located in every state in the country. They can be leveraged to quickly build a new network, optimize your network by filling in gaps, or expand it into a new area.  If you want to use your own providers, we can help with credentialing. We have an experienced team dedicated to the task, and our processes meet most CMS requirements. Additionally, we thoroughly understand state requirements, including notification and processing time frames, and meet them as necessary.

“MultiPlan's ability to quickly deliver Medicare-contracted provider access was instrumental to our plan serving our members. Their network also helped us to receive approval to expand into nearby counties. Our account manager was fantastic. MultiPlan's turnaround from discussion to contract execution was really fast, and they worked diligently to meet our budget constraints as well. They are a class act.”

CEO, Medicare Advantage plan
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MultiPlan’s Medicaid Network Services

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MultiPlan has partnered with several leading  Medicaid plans to support a variety of programs since 2004. Today our Medicaid networks provide access to healthcare providers for people who receive care through Medicaid and other Medicaid-related programs administered by our clients, and we have developed statewide and regional access to help meet our clients’ network adequacy requirements. We can build an entire network or fill in a specific part of an existing network. With over 15 years of experience in building, managing and servicing Medicaid networks by providing essential community providers, we understand the needs of our clients and have demonstrated success in building the bridge between members and providers. 

Payment Integrity Services

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Claim Correction, a payment integrity service,  reviews claims before payment and identifies billed services that are not compliant with medical coding rules. The service increases payment accuracy while reducing inappropriate medical spend.

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Quickly built custom TRICARE networks

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To help a TRICARE plan administrator provide healthcare support to U.S. military and their families, MultiPlan built a network of 23,000 healthcare providers in only six months. What’s more, we did it in the middle of winter. Our dedicated team braved travel to Alaska, Minnesota, and North and South Dakota in harsh weather conditions to personally recruit providers.

Let our network development expertise, and the nearly 900,000 NCQA-accredited providers we already contract with, help deliver speed to market for your public-sector health plans.

Contact us

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Let MultiPlan’s custom network development and payment integrity services improve the competitiveness and effectiveness of your public-sector healthcare programs.