NextSphere has designed solutions to help providers improve healthcare delivery while maximizing the benefits of technology to effectively manage costs across the healthcare market.
We build next generation platforms for plan-management and claim-administration solutions which can be easily configured for various claims management processes such as Medicaid, Medicare, and Commercial. These platforms provide a low-maintenance delivery model to reduce errors, administrative expense, and IT expense while maximizing flexibility.
Processing claims well is a significant part of successfully managing a healthcare organization. We have deep experience in building claims-processing engines that automate and complete many administrative tasks, bringing greater accuracy and efficiency to claims processing. This translates to reduced administrative costs, as more claims are correctly processed the first time.
Our team understands the requirements of member enrollment solutions and have designed solutions to provide enrollment and reconciliation services. These systems automate the complexity of CMS data exchanges efficiently and accurately, reducing the administrative costs.
Health plan provider portals aggregate information and functionalities from the health plan claims-processing system or IPA sub-systems which offer information sharing between payers and health plans.
The Independent Practice Association – Management Service Organization (IPA-MSO) provides extensive software solutions for independent physicians, including member enrollment, care management, claims, authorizations, health plans, IPA’s, providers, credentials, and more.
An electronic health record (EHR) is a digital version of a patient’s paper chart. EHRs are real-time, patient-centered records that make information available instantly and securely to authorized users. While an EHR does contain the medical and treatment histories of patients, an EHR system is built to go beyond standard clinical data collected in a provider’s office. NextSphere has experience in building EHR systems, certified for Meaningful Use I, II, and III, and Physician Quality Reporting System (PQRS) reports.