Healthcare Plans and Providers Can Serve Patients Faster – Here’s How

One of today’s top challenges in healthcare is that providers and health plans alike are bogged down by disconnected systems. Team members using those systems every day find themselves steeped in administrative tasks or cross-referencing information multiple times, leading to decreased productivity and inferior user experiences. Health plans face this challenge regularly when working with new or existing providers, as network management involves many time-consuming administrative processes. It can take health plans anywhere from four weeks to four months to credential a provider, delaying not only their onboarding process but the ability to efficiently and quickly provide care to patients.

When it comes to setting up new provider networks or expanding existing ones, the demand for networks to develop more efficient operations that reduce or eliminate time-consuming processes will continue to grow. Investing in an interoperable platform, or a “digital bridge,” that connects various systems and digitizes manual processes can speed the length of time it takes a provider to onboard into a network and make ongoing communication and collaboration much more seamless. Organizations like EmblemHealth have taken the plunge and are seeing how much better their operations and provider relationships have improved as a result. “Salesforce allows us to provide better customer service interactions in a more cohesive way and predict how we should engage next. [The platform] also delivers critical insights around providing better health and wellness to our members and providing better information to our provider partners,” said Tom MacMillan, CIO at EmblemHealth.

Here are five steps you can take to get started on the path to improving provider network management with a digital bridge made possible with a connected platform.

Step 1: Analyze the network

List your current providers and identify potential new ones and create an adequacy report. With this report, you can quickly see where you lack providers in certain areas such as specialty or geographic location.

Step 2: Ramp up recruitment

Create an outreach campaign targeting new providers based on the gaps you identified. With automated email campaigns that include personalized journeys, you can engage providers and follow up on leads.

Step 3: Automate the application process

Once a provider or provider group has shown interest in joining your network, engage them via digital channels such as email and make applying a breeze. Automated workflows on your application portal can intuitively guide providers and make applying quick and simple. With a digital portal integrated into a network management system that’s easy to use, you can remove some of the friction from the application process leading to a better experience for applying physicians.

Step 4: Minimize credentialing and contracting constraints

Once an application is submitted, it undergoes a slew of manual data-collecting processes and reviews that can Once an application is submitted, it undergoes a slew of manual data-collecting processes and reviews that can take months to complete. By using a connected platform that directly pulls in credentialing data such as Council for Affordable Quality Healthcare (CAQH) data, you can cut the time it takes to credential and contract a provider down to weeks. Digital bridges allow you to easily submit provider information to credentialing organizations electronically while allowing providers to track the progress of their applications digitally, greatly reducing turnaround times and overhead costs.

The creation and management of various provider contracts tends to be complex and time-consuming as contracting specialists are often handling multiple contract versions, ever-changing terms and renewals. With an integrated platform, the contract management process from draft to negotiation to execution can be digitized and streamlined. Specialists can have visibility into the status and progress of every contract with configurable qualitative and quantitative attributes. This newfound visibility can improve employee productivity, data management and accuracy, and enhance provider relationship management and experience.  Moving a largely manual, friction-filled process onto a digital platform can help create smoother and faster credentialing and contracting processes for health plans and providers.

Step 5: Empower providers

Your digital bridge can enable better communication and collaboration with providers, whether its at the last mile of the application process where signature technology like Docusign can eliminate the need for paper signatures to expedite contracts, or, through the onboarding processes where you can arm them with the knowledge they need to make sure they know both your organization and your systems inside and out. Speeding up processes using your digital bridge platform can then help providers deliver care faster.