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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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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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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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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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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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.
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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Fee Negotiation
NSA/QPA
Out of Network
Payment Integrity
Provider Contract Repricing/Contract Management
Provider Network
Specialty PBM
Unity Preferred Networks
Unity Preferred Network specializes in Direct Contracting, ensuring cost savings without the headaches of RBP. Unity helps out TPAs and Health Plans optimize costs without friction and is here to be utilized in a Primary and Secondary manner, sitting in front of RBP for all of our clients to exhaust all of our resources to solve claims issues.
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Fee Negotiation
NSA/QPA
Out of Network
Payment Integrity
Provider Contract Repricing/Contract Management
Provider Network
Specialty PBM
Valenz
Valenz Health is the platform to simplify healthcare – the destination for employers, Payers, providers, and members to reduce costs, improve quality, and elevate the healthcare experience. Valenz engages early and often for smarter, better, faster healthcare.
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