Customized Solutions for Government Healthcare Plans
Customized government healthcare networks and payment integrity programs
Value we deliver
- Healthcare networks provide access to high quality healthcare providers for the most vulnerable populations
- Healthcare payment integrity resolves waste and abuse before you pay, so you spend less time and money reclaiming overpayments
Programs we serve
- Medicare Advantage
- Medicaid and CHIP
- Federal and State Agencies
Best in class network-based services for Medicare Advantage plans
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.
Network Services for Medicare Advantage Plans
Through 2023, enrollment in Medicare Advantage is expected to increase 4-6%, becoming the single biggest driver of profit growth for healthcare payors. At the same time, CMS has accelerated their filing timeline for network adequacy, making it a challenge to take advantage of growth opportunities. Whatever you need to take advantage of this opportunity, MultiPlan can help. Whether you want to expand an existing network to maintain CMS adequacy, fill in network gaps to maintain adequacy, build a new network, or offer network access to traveling members, our flexible services can handle it. Tell us which providers to recruit or let us conduct an adequacy analysis and build a target list. We can do all of the recruiting or team up with you based on geographical regions, specialties, specific providers or other parameters. We’ll contract using your paper or ours, and either way, we’ll do the credentialing and data maintenance, if you want us to. Tell us what you need, and we’ll put our 15 years of government network experience and longstanding relationships with 800,000 Medicare Advantage-appropriate providers to work for you.
MultiPlan’s Medicaid Network Services
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
Advanced Code Editing, 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.
Quickly built custom TRICARE networks
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.
Let MultiPlan’s custom network development and payment integrity services improve the competitiveness and effectiveness of your public-sector healthcare programs.