The MacroHealth Intelligent Exchange™ (MiX) platform helps Payers design strategic and cost-effective solutions for out-of-area and out-of-network care, supporting smarter architecture and better member access.
Contact Us to Learn MoreOut-of-area strategies help provide coverage for quality, low-cost care to members that travel to or live outside the primary area the plan covers, while out-of-network solutions help manage claim costs that are outside of in-network contracts. This ensures that your members receive better coverage, lower costs, and less balance billing – contributing to an overall improved member experience.
With MacroHealth, gain access to market data, coupled with industry-standard interoperability that equips Payers with the means to curtail claims and administration costs, ultimately elevating the quality of care delivered.
Explore the MiX PlatformThe MiX platform analyzes Payer’s claims and identifies Health Market Partners that could increase coverage for members and reduce overall claims costs.
MacroHealth connects Payers and Health Market Partner that best fits their needs, through a single, reusable data connection.
Use a variety of tools for out-of-network costs, including payment integrity solutions, NSA solutions, and payment negotiation.
Case Study
UHA Health Insurance, based in Honolulu, Hawaii, sought guidance in their search for a more comprehensive mainland network solution.
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Brochure
MacroHealth has built a multi-sided platform to modernize the healthcare marketplace by providing Payers with the ability to…
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Blog
In the ever-evolving landscape of healthcare pricing, a pressing question emerges: How will out-of-network (OON) healthcare costs be impact…
Learn MoreLeverage advanced analytics and data science to optimize your solutions for cost and quality objectives.
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Witness data-driven healthcare transformation firsthand. Request exclusive access to the MiX Platform Demo video now.