IPAs & MSOs
Delegated credentialing, capitation adjudication, and network leakage analytics for risk-bearing entities managing complex provider networks.
Built for Risk-Bearing Entities
IPAs and MSOs operate at the intersection of provider management and payer risk. You need infrastructure that handles capitation, delegation, and network integrity — all at once.
Delegated Credentialing
End-to-end credentialing management for your provider network — primary source verification, re-credentialing cycles, and NCQA delegation compliance.
Capitation Adjudication
Automated cap payment reconciliation, sub-capitation distribution, and risk pool settlement — ending month-end chaos and manual spreadsheets.
Network Leakage Analytics
Identify out-of-network referral patterns, quantify leakage revenue impact, and implement steerage strategies to keep care in-network.
Risk Pool Management
Real-time IBNR estimation, stop-loss tracking, and surplus distribution modeling so you always know your risk position.
Claims & Encounter Data
Clean encounter data submission to health plans, claims processing for delegated arrangements, and EDI 837/835 reconciliation at scale.
Provider Network Operations
Provider directory management, contract loading, fee schedule maintenance, and network adequacy monitoring for regulatory compliance.
Results for IPAs & MSOs
Strengthen Your Network's Financial Core
Schedule a consultation to see how Zenexa optimizes delegation, capitation, and network performance for risk-bearing entities.