Intelligent Health Marketplace Directory

Explore the range of Health Market participants serving Payers on the MacroHealth Intelligent Exchange™ marketplace. Identify categories to optimize your healthcare spending or enhance your offerings, and learn about the companies available in each optimization.

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6 Degrees Health  

Fee Negotiation

NSA/QPA 

Out of Network 

Payment Integrity 

Provider Contract Repricing/Contract Management 

Provider Network 

Specialty PBM 

6 Degrees Health  

6 Degrees Health is a healthcare cost containment company focused on superior results and customer experience. We use clinical expertise and technology to ensure fair reimbursements and improve payment accuracy.   

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Ceris 

Fee Negotiation

NSA/QPA 

Out of Network 

Payment Integrity 

Provider Contract Repricing/Contract Management 

Provider Network 

Specialty PBM 

Ceris 

As a leader in claim reviews, CERIS uses clinical expertise to ensure accuracy in healthcare payments. With over 30 years of experience in Prepay, its universal chargemaster contains items from over 97% of the nation’s hospitals, ensuring accuracy and an objective claim review. 

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ClearHealth Strategies

Fee Negotiation

NSA/QPA 

Out of Network 

Payment Integrity 

Provider Contract Repricing/Contract Management 

Provider Network 

Specialty PBM 

ClearHealth Strategies

ClearHealth Strategies offers top technology and services for reference-based pricing, out-of-network, supplemental network and surprise billing programs with a turnkey approach to manage profile building, claim pricing, balance billing, hold harmless, and arbitration (IDR) processes.   

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CMSPricer  

Fee Negotiation

NSA/QPA 

Out of Network 

Payment Integrity 

Provider Contract Repricing/Contract Management 

Provider Network 

Specialty PBM 

CMSPricer  

CMSPricer is a Medicare pricing/editing and Contract Manager technology solutions company. Our Contract Manager solution easily loads all network contracts and processes all claim types based on both Medicare and non-Medicare fee schedules.  

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NovaNet  

Fee Negotiation

NSA/QPA 

Out of Network 

Payment Integrity 

Provider Contract Repricing/Contract Management 

Provider Network 

Specialty PBM 

NovaNet  

NovaNet is a PPO delivering network coverage with a distinct perspective, and it is not owned by physicians, hospitals or insurance carriers. This allows NovaNet to creatively collaborate with its clients to deliver the most effective products and services for members.  

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Plotkin Health 

Fee Negotiation

NSA/QPA 

Out of Network 

Payment Integrity 

Provider Contract Repricing/Contract Management 

Provider Network 

Specialty PBM 

Plotkin Health 

Plotkin Health is a medical cost containment company serving over 50 national & international health insurers. Specializing in all facets of medical loss mitigation, Plotkin Health is your trusted partner in fair, ethical and simple healthcare claim resolution.  

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