
Through our own proprietary software, Evolutions has a solution for all network and repricing needs from contracting through claims handling and repricing. Our software development team has created a robust yet flexible system engine adept at interpreting, calculating and repricing claims based on complex matching protocols and showcasing custom directories that effectively represent the most complex network tiering and benefit designs.
Evolutions provides a comprehensive suite of healthcare management solutions and claims processing services including EDI, customized directories, out of network savings solutions, analysis, reporting and more!
We are engaged in the pursuit of actively managed EMPLOYER-BUILT Healthcare to replace the archaic passively managed Insurer-Built Healthcare system that has ceased to meet the needs of employers and their employees providing best-in-class benefits at substantially lower costs, all while improving clinical and financial outcomes for our clients’ health plan and their employees.



