Centralizing Provider Contract Information - Case Study: Scott and White Health Plan

 

Challenge

 

Paper Contracting Inhibits Data Accessibility

Scott & White Health Plan, named the Highest Ranked Health Plan in Texas by US News & World Report in 2005 and 2006, prides itself on delivering high-quality care to its over 200,000 members.

To deliver this level of service, Scott & White has worked diligently on its relationship with its provider network and continually looks for areas of improvement. One of these areas was provider contracting. Until recently, Scott & White was dependent on manual provider contracting processes and lacked a centralized repository of contracting information, often causing tension between their health plan and their provider network.

Solution:

 

Streamlined Provider Contract Management

Scott & White Health Plan selected Portico Choreo Contract Manager to meet their provider contracting needs. Choreo has enabled their provider contract department to:

• Manage the provider contracting workflow from creation to execution. Using simple contract creation wizards, thousands of contracts can be created with the click of a mouse.
• Provide a full audit trail for each contract, including who altered it and when. Extensive, accurate audits can take just a matter of minutes, avoiding the expense of hiring external consultants.
• Enforce compliance, both in workflow and language. Portico Choreo offers safeguards to ensure that contracting personnel use pre-approved language and rates when creating contracts.

Results

 

Increased Provider Contracting Efficiency and Data Availability

With the implementation of Portico Choreo Contract Manager, Scott & White Health Plan has been able to reduce their reliance on paper and create a centralized repository of contract information. Additionally, the contracting workflow is now more efficient and is an asset in the drive to continually improve the relationship between Scott & White and their providers.