Network Management

Analyze your network compared to competitors, assessing provider negotiated rates and detailed coverage by county for a competitive advantage.

Challenge

Network Managers must ensure compliance with regulatory standards which mandate an adequate provider network. At the same time, they are tasked with establishing a high-quality pool of providers, assessed on factors beyond minimum requirements. Virtical helps network managers address network adequacy and stay compliant using artificial intelligence to identify gaps in network coverage by specialty and county.

Book a Live Demo

Name
Email
Phone
Source
Page

About the Solution

Virtical assists in identifying gaps in your network - holistically as well as by customer and prospect - by comparing provider and member locations, allowing payers to strategically promote their network coverage strengths as well as address deficiencies to ensure members have access to adequate providers within their area. Payers can also compare negotiated provider rates with those of their competitors, helping them to gain insight into how their rates stack up against other networks and where to immediately target marketing spend.

  • Network gaps by speciality & county
  • Compare provider-negotiated prices cross-payer
  • Recruit the best providers based on recommended priority, price and ratings
  • Compare network against employee distribution in large organizations
  • Seamless integration with Simplify Platform

Virtical Apps integrate seamlessly with the Simplify Platform platform, across Sales, Service, Health, and Experience Clouds. Virtical's User Experience (UX) layer is integrated with Simplify Platform and blended into business processes such that the insights derived from our AI models are delivered to your users in the right place at the right time. Moreover, Virtical offers configuration tools that allows in-house customization of these Prebuilt apps as per the unique needs of your business. These ready-to-use, yet tunable applications fast-track digital transformation, freeing up your team to focus on more strategic tasks. Integration of Virtical with Simplify Platform is therefore not just an optimized solution for the health insurance sector, but also a catalyst for bringing about technological innovation within your organization.