SERVICES

NEXtCARE offers first-rate TPA services but it doesn’t mean prices come at a premium, and this is especially true when managing medical provider rates. Before deciding on hospital or clinical care, we perform data analysis and benchmark against network standards of pricing and utilization, and competition offerings. Enjoying scale, breadth and depth of beneficiaries and support networks, we are in a position to negotiate more viable care packages and category rates.

NEXtCARE enjoys strong leverage when it comes to providers’ contract controlling procedures, including pre-approval protocols for different network tiers, claim submission and resubmission practices related to penalty and denial timelines. Our management contract with medical providers comes with built-in performance, pricing and claims monitoring tools to continuously safeguard the interests of all beneficiaries and their sponsors.