Advanced Network Administrator



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Guaranteeing Integrity for Provider Information

Advanced Network Administrator (ANA) is a complete provider contract and network management system. ANA organizes and manages the tasks associated with provider data management using advanced database methodologies. It represents a data warehouse for importing, maintaining and exporting network, provider and contract information. ANA accommodates all of the data needs associated with credentialing, geo-access, security, contract pricing and claims with an ability to integrate to the health plan or the payor's claims payment process. ANA provides a smooth and efficient process for automating multiple PPO networks and contracts.

Serving as a central processing framework for all aspects of provider change management, ANA eliminates the data integrity problems and conflicts associated with traditional provider record keeping within the claims process.

ANA Features

  • Search Engine-powerful and comprehensive search engine with variable field selection criteria.
  • Master files-non-redundant set of relational data bases for supporting all provider management activities. Provider name and address files for supporting multiple address and locations.
  • Data cleansing-Scrub processes engineered to cleanse and normalize data prior to use within the ANA framework.
  • Translator-provider data mapping and translation to support any PPO import format.
  • Creates contract masters-automated process to create contract master records during the import process
  • Duplicate check-detects duplicate provider records during the import process
  • Auto mapping-provides a mapping tool that eliminates the need for special customized data translator programs. These tables have been engineered to allow for the mapping functions to be established once and then used on a recurring basis during each import cycle.
  • Network and Payment prioritization-allows for the users to control the payment reimbursement priority when multiple PPOs and payment methods are under contract.
  • Interface capability-allows for the automated integration of provider contract data to the claims payment provider data base without interrupting the claims payment process.

The responsible PPO network solution

AMRHEALTH’s Advanced Network Administrator is a knowledge-based cost containment tool that can improve the financial performance of a health plans. It is designed to work as an integrated component of AMRHEALTH’s suite of managed care reimbursement solutions, as a stand alone component or integrated into your existing legacy applications.

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