Provider & Administrative Services

The Envolve family of companies partners with you to provide the strategies, people and processes needed to lead the way in value-based care and drive real healthcare transformation through its healthcare administrative services and healthcare BPO. With a wide and flexible catalog of services featured below we are able to tailor our healthcare provider services and solutions to meet our partners’ financial, performance and health outcome goals.

Claims Adjudication

Claims Adjudication

Envolve recognizes encounter data is critical to risk adjustment and program integrity and provides both accurate and complete original encounters submissions, as well as supplemental diagnosis data. As part of our healthcare administrative services, Envolve provides accurate and complete original encounters submissions and supplemental diagnosis data in HIPAA compliant paper and EMR formats.

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Encounters/Processing

Encounters/Processing

Envolve understands that good claims in means a good encounter out. As a leader in healthcare services, we make sure our claims processing is efficient, effective, and accurate to support downstream encounter data production.

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Management Services

Management Services

Envolve's management services allow for better healthcare administration and efficiency in delivery of care through services in business administration, effective data utilization, clinical excellence, and operational support.

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Member Services, Eligibility & Enrollment

Member Services, Eligibility & Enrollment

Envolve's Member Services, Eligibility and Enrollment programs ensure individuals are enrolled in the right programs right from the start.

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Provider Network Management

Provider Network Management

Envolve uses a modular platform for contracting, service inquiry, documentation, and data management to effectively and efficiently manage provider networks. 

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Quality Program Management

Quality Program Management

Envolve is committed to Quality Improvement/Utilization Management (QI/UM) Programs using reliable and valid methods of monitoring, analysis, evaluation, and improvement. 

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