Health Network Solutions

What Health Network Solutions does

Health Network Solutions (HNS) is a clinically integrated chiropractic physician network headquartered in Cornelius, North Carolina, that contracts with health plans, managed care organizations, employer groups, and public sector entities to provide access to credentialed chiropractic providers. Founded in 1996, the company operates two differentiated provider network tiers (High Performance Network and Access Plus Network) and delivers a portfolio of delegated managed care services including NCQA-certified credentialing and recredentialing, utilization management, quality assurance, clinical support programs (continuing education, peer collaboration, cultural competency, peer-to-peer counseling), pay-for-performance incentives, and centralized claims administration.

The technology backbone is HNSConnect, a proprietary secure portal for providers and payors that supports credentialing workflows, claims administration, and electronic data interchange (EDI) for claim submission and remittance. HNS also maintains a rules-based analytics platform for business intelligence and an extensive library of proprietary clinical and administrative forms (examination forms, Bournemouth questionnaires, Oswestry Low Back Pain Disability Form, Roland Morris Questionnaire, HIPAA Privacy Notice, W-9 forms). The company is NCQA-certified for credentialing functions and reports serving millions of covered lives under contract.

HNS generates revenue through network management fees charged to payors for access to its credentialed provider network and for delegated administrative services, with pricing structured as integrated, stand-alone, or customized solutions. Single-signature contracting under a single EIN allows payors to access the entire network through one agreement. The go-to-market is direct sales to enterprise payor clients combined with provider recruitment through field representatives and self-service channels (website, provider directory, downloadable forms). The company reports 100% client retention at contract renewal and operates primarily in the Southeast United States with multi-state and national coverage capabilities.

Name

Health Network Solutions

Legal name

Health Network Solutions, Inc.

Website

https://healthnetworksolutions.net

Company type

Private

Founded year

1996

Operating status

Operating

Headcount range

11–50 employees

Short description

Health Network Solutions is a clinically integrated chiropractic physician network founded in 1996 that contracts with health plans, managed care organizations, employers, and public sector entities to provide credentialed provider access, delegated credentialing, claims administration, and clinical programs across the Southeast United States.

Ownership category

akta.pro rank

Product category

Chiropractic Network Management

NAICS

Ambulatory Health Care Services (621)

SIC

Services-Health Services (8000)

akta.pro primary industry

Provider Network & Care Management for Commercial Members (HLAEAAAL)

Keywords

• Chiropractic network management
• Managed care services
• Provider credentialing
• Claims administration
• Utilization management

Headquarters

HQ city

Cornelius

HQ country

United States

HQ region

North America

Offices2 records

Markets served

GTM type

B2B

Offering type

Services

Cost components

Personnel, Operations, Technology or R&D, Marketing or Sales, Supply Chain

Revenue model

1. Network Management Fees: HNS generates revenue through network management fees charged to health plans and payors for access to their credentialed network of chiropractic providers, administrative services, and quality programs. The company provides integrated, stand-alone, and customized solutions tailored to client needs.
2. Provider Contracting Services: Revenue from single signature contracting services that allow payors to access conservative treatment options through HNS's network of providers under a single EIN, simplifying administrative processes.

Go-to-market motion2 records

Distribution channels3 records

Marketing channels4 records

Core offering

Health Network Solutions operates a clinically integrated chiropractic physician network that provides network development, provider credentialing, claims administration, utilization and quality management, and client services to health plans, employers, managed care organizations, and government agencies across multiple U.S. states. Its product portfolio includes the High Performance Network, the Access Plus Network, and the proprietary HNSConnect technology platform that supports payer-side administration of chiropractic benefits. Operations are NCQA-certified for credentials verification, utilization management, and quality improvement.

Product overview

Health Network Solutions (HNS) operates as a clinically integrated chiropractic physician network offering a platform of administrative and clinical solutions. The portfolio centers on HNSConnect, a proprietary secure portal for providers and health plans, complemented by two credentialed provider networks (High Performance Network and Access Plus Network). Supporting modules include Clinical Forms (examination and outcome assessment tools), Administrative Forms (claims processing, credentialing, compliance), Electronic Data Interchange (EDI) for claims submission, NCQA-certified Provider Credentialing Services, Utilization Management, Quality Assurance Programs, Clinical Support Programs (CEUs, peer collaboration), Pay for Performance incentives, and Central Claims Administration. The integrated solution enables payors and providers to manage chiropractic care delivery, reduce administrative burden, and improve clinical and financial outcomes through single-signature contracting under one EIN.

Differentiator

Problem solved

Functional benefit

Brands

• HNSConnect: Electronic solutions platform providing administrative support, claims processing, and provider portal services.

Products and services

• High Performance Network A clinically integrated chiropractic physician network product offered by HNS to health plans, employers, MCOs, and government agencies for outsourced management of their chiropractic benefit.
• Access Plus Network A second clinically integrated chiropractic physician network product offered by HNS to payer clients as an alternative access option for outsourced chiropractic benefit management.
• HNSConnect Proprietary technology platform used by HNS to deliver its network management services, supporting administrative forms, clinical forms, and EDI transactions for payer and provider workflows.
• Provider Network Management and Credentialing Services Outsourced provider network recruitment, contracting, and NCQA-certified credentialing services delivered to health plans, employers, MCOs, and government agencies.
• Claims and Utilization Management Services Centralized claims administration and NCQA-certified utilization management services for chiropractic benefits, including EDI processing and clinical review.

Quantifiable outcome

• 100% client retention at contract renewal
• +2 more outcomes

Named customers3 records

Segments3 records

Ideal customer profiles1 record

Technology focussed No

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

Feature4 records

Partnerships

One partnership is on record.

• Health Care Professionals (Chiropractic Physicians)coreChannel Partner/ Reseller/ DistributorHNS maintains strategic partnerships with a network of chiropractic physicians who provide conservative treatment services to health plan members. Providers benefit from credentialing, administrative support, and access to patient populations through HNS contracts with payors.

Scale indicators4 records

Recent moves5 records

Expansion highlights4 records

Broad incumbents

• Optum Health (UnitedHealth Group): Optum Health is a diversified care delivery and network management business within UnitedHealth Group, serving commercial, Medicare, and Medicaid populations. Comparable to HNS in operating provider networks and contracting with health plans, but at massive scale and across all specialties.
• eviCore (Evernorth/Cigna): eviCore is a large specialty care management company providing utilization management and network solutions for payers. Comparable to HNS in offering utilization management and quality programs for specialty services, but operates at much larger scale across many specialties.
• MultiPlan: MultiPlan is a large-scale provider of network management, cost containment, and claims processing services to payors, employers, and TPAs. Comparable to HNS in serving health plans with network and claims management, but operates at much greater scale across multiple specialties and provider types.
• Zywave (formerly Windhaven): Zywave provides commercial insurance technology and network solutions. Less directly comparable but operates in adjacent commercial-payor infrastructure space where HNS competes for payer attention and budget.

Direct peers

• American Specialty Health (ASH): ASH is the largest complementary and alternative healthcare network in the U.S., offering chiropractic, acupuncture, massage therapy, and fitness benefits to health plans and employers. Directly comparable to HNS in business model (provider network management with credentialing, claims, and quality programs) but operates at significantly larger national scale.
• ChiroCare by Optum/ACN Group: ChiroCare (American Chiropractic Network) is a national chiropractic network offering credentialing, provider access, and care management to health plans and employers. Directly comparable to HNS as a specialty chiropractic network serving the same payer clients and provider populations.
• Fulcrum Health: Fulcrum Health is a specialty network management company focused on chiropractic, physical therapy, and occupational therapy services for health plans. Closely comparable to HNS in specialty focus, payer clients, and credentialing/quality programs, with overlap in target customer base of health plans and managed care organizations.

Regional players

• American Health Holdings: American Health Holdings provides care management and utilization review services for health plans. Comparable to HNS in delivering payer-facing clinical and administrative services, though focused on different therapeutic areas and serving different regional markets.

Market position

Strengths5 records

Weaknesses5 records

Competitive moat4 records

Key risks5 records

Key highlights6 records

Customer concentration

• LinkedInlinkedin.com/company/health-network-solutions

Revenue estimate

Valuation estimate

Number of profiles

Profiles1 record

Funding overview

Funding rounds

Investors

Funding detail is available on the Subscription and Enterprise plan.Contact sales →

M&A

Investments

M&A and investment is available on the Subscription and Enterprise plan.Contact sales →

Frequently asked questions about Health Network Solutions