Provider Network Management Solutions

We offer providers a value-based reimbursement model centered on aligning quality measures, HEDIS measures and HH incentives to reward high-quality care of the members you serve.

These healthcare provider network management offerings help reduce waste, slow the growth of costs, and improve the health of individuals covered under your plan.

Be More Informed About Your Provider Network

Provider Network Management solutions offered by Envolve Health provide health plans & payers with robust analytics tools and near real-time transactional data to help providers become aware of the statuses and the outcomes of their patients through timely reporting.

Envolve’s Provider Portal provides access to:

• Patients' care plans
• Authorizations
• Medical and pharmacy claims utilization data and
• Lab test results  

The Envolve Provider Portal supports  healthcare providers in their practice of evidence-based medicine. Providers have access to actionable information, dashboards and a number of administrative self-service capabilities and clinical applications. Self-service capabilities of our provider portal include:

• Secure messaging
• Eligibility inquiry
• Authorization submission
• Online claim submission and claim status inquiry
• Referral options for patients regarding care and disease management

Clinical capabilities include:

• Care Gap Notifications (Direct Care Alerts)
• Patient Panel including disease registry
• Patient Health Record
• Patient Care Plan
• Practice-level clinical quality and cost reports
• Clinical practice guidelines
• Practice Improvement Resource Center, a searchable compendium of information on evidence-based toolkits and best practices, practice guidelines, multi-media content, and interactive tools to help providers manage the clinical, operational, and technology aspects of their practices

Partner With Envolve For Innovative Healthcare Provider Network Management Solutions

Payers and providers benefit with Envolve Provider Network Management Solutions, allowing for more effective management of care coordination and delivery.

Be better informed and focus on improving outcomes and reducing healthcare costs with support from Envolve Health. Provide outstanding support for your providers. Contact us to get started today! 

HEDIS^® is a registered trademark of the National Committee for Quality Assurance (NCQA).