Optimize provider & performance
with actionable insights

IntelliPayer Provider

IntelliPayer Provider helps healthcare payers to manage provider lifecycle processes including provider operations, network adequacy optimization and provider performance management to improve patient experience and maintain business profitability. Our end-to-end provider management solution allows payers to improve quality and drive revenue through value-based service delivery.

Business Challenges

Managing the provider network in this competitive healthcare industry is a huge task for payers. Healthcare payers need superior provider network management for managing network with greater efficiency and attainment of optimum financial results to increase provider satisfaction and reduce errors.

Measure risk adjusted provider efficiency

Estimate and monitor key metrics such as network leakage and quality measures

Provider performance and efficiency

Evaluate members by type to make informed decisions

Key Features

Pro-active evaluation and management

Allow pro-active estimation and management of key processes involving providers through streamlined dashboards and analytics

Value-based care models

Redesign the care and payment models to detect new risk and opportunity

Manage relationships with providers

Assist in managing relationships with providers, which leads to increased provider satisfaction and retention

Cost management

Enable improved MLR through better cost management

Provider segmentation

Create an efficient, scalable and flexible IT foundation to segment providers based on specialty, utilization, cost, and geography criteria

Integrate data from various sources

Integrate unstructured and structured data from multiple sources to measure performance

Business Benefits

Using our provider analytics solution gives you an insight into the cost and performance of your providers so you can address value
and usage, and provider practice patterns.

Identify potential provider partners

Identify provider partners for risk-based arrangements

Care improvements

Structure bundled payments for care improvements

Better provider engagement

Improve provider transparency and optimize engagement

Manage provider

Proactively manage providers to pinpoint cost drivers, and monitor risk scores

Find the solution that meets your need


From member growth and retention to medical cost management, IntelliPayer is opening up other avenues and opportunities in healthcare, which includes combating fraud, driving product design, and strengthening quality of service delivery etc.

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