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AaNeelCare® Provider Portal

Connected Intelligence for Stronger Provider Engagement

Today’s providers need more than access to information. They need a connected digital experience that brings clinical, administrative, quality, and member information together at the point of action.

The AaNeelCare® Provider Portal creates a secure connection between health plans and their provider networks, giving providers timely access to the information, workflows, and insights needed to manage members across the continuum of care. From eligibility and prior authorization to claims, quality, risk adjustment, referrals, and care management, AaNeelCare® brings critical functions together in one connected environment.

By reducing fragmented workflows and improving visibility across member information, AaNeelCare® helps health plans strengthen provider engagement while giving providers the tools to turn information into action.

AaNeelCare-Provider-Portal

A Connected View of the Member

Meaningful provider engagement starts with meaningful information.

AaNeelCare® creates a unified member view that brings together demographics, clinical history, medications, care plans, care gaps, utilization, and other relevant information within a secure workspace.

By connecting information across the member journey, providers gain greater visibility into care needs, recent activity, and opportunities for follow-up without navigating multiple disconnected systems.

Provider Dashbord

Connected Workflows Across the Provider Experience

Eligibility and Member Benefits

Eligibility & Member Benefits

Verify member eligibility, coverage, benefits, and cost information through a connected workflow that gives providers timely information before and during the delivery of care.
Risk Adjustment

Risk Adjustment

Support risk adjustment workflows through documentation, chart submission, encounter tracking, and identification of incomplete or rejected information.
Medicare Advantage Quality

Medicare Advantage Quality

Turn Stars measures and member-level care gaps into actionable information that helps providers identify opportunities for follow-up and support quality performance.
Documents & Resources

Documents & Resources

Provide centralized access to current policies, manuals, forms, guidance, training materials, and health plan notices within one trusted resource center.
Referrals and Care Management

Referrals & Care Management

Connect referrals, transitions of care, and care management activities to support coordination among providers, specialists, care managers, and health plans.
Clinical Information

Clinical Information

Surface relevant clinical information, including medications, care gaps, admissions, discharges, and clinical alerts, to help providers identify emerging needs and take appropriate action.
Appeals, Disputes and Grievances

Appeals, Disputes & Grievances

Manage submissions, supporting documentation, deadlines, determinations, and escalations through a transparent digital process with visibility throughout the request lifecycle.
Provider Directory and Network Management

Provider Directory & Network Management

Maintain accurate provider and network information with centralized access to provider profiles, network status, credentials, rosters, and directory information.
Secure Communications

Secure Communications

Connect securely with provider services, claims, credentialing, utilization management, and care teams through case-specific messaging that keeps communication connected to the work being performed.
Analytics & Performance

Analytics & Performance

Access to dashboards and configurable reporting provides visibility into utilization, quality performance, operational metrics, and population health, helping organizations monitor performance and identify trends across their provider network.
Prior Authorization

Prior Authorization

Manage electronic prior authorization from submission through determination. Providers can submit requests and support clinical documentation, track status, review determinations, and manage related appeals through a streamlined workflow.
Security - Privacy and Compliance

Security, Privacy & Compliance

Protect member information through secure authentication, role-based access, multifactor authentication, encryption, audit controls, and standards-based data exchange. AaNeelCare® is HITRUST certified, supporting the security, privacy, and governance requirements of today’s ACOs, IPA/MSOs, health plans, and provider organizations.
Supporting Value-Based Care at the Point of Action

Supporting Value-Based Care at the Point of Action

Value-based care requires more than retrospective reporting. Providers need visibility into what is happening across their member population and the insight to know where attention is needed. AaNeelCare® connects member-level information with quality, utilization, risk, and performance insights, helping provider organizations identify opportunities, prioritize action, and advance value-based care objectives.
Strengthening Health Plan and Provider Collaboration

Strengthening Health Plan and Provider Collaboration

A Provider Portal should be more than a place to retrieve information. It should create a meaningful digital connection between the health plan and the providers caring for its members. AaNeelCare® strengthens that connection through shared information, secure communication, and integrated workflows that increase transparency, support collaboration, and connect care across the healthcare ecosystem.
Claims

Claims

Gain timely visibility into claims activity, including visit dates, provider information, claim status, payment details, and member responsibility. AaNeelCare® also helps identify members who have not been seen, pending Annual Wellness Visits, MRA and care gaps, and missing claims, giving provider teams actionable information to support follow-up, risk adjustment, quality, and population health activities.
Provider Reporting & Actionable Quality Scorecards

Provider Reporting & Actionable Quality Scorecards

Bring member, care gap, medication, documentation, and performance information together through customizable reports and scorecards. Providers and health plans gain greater visibility into performance, outstanding activities, and areas requiring attention.

One Portal. One Connected Provider Experience.

AaNeelCare® connects health plans and providers through a unified view of the
member, bringing clinical, quality, administrative, and operational information together to support
engagement,collaboration, and value-based care.

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