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Provider Self-Service

The Provider Self-Service solution presents a significant opportunity to decrease administrative costs while improving provider satisfaction. It enables online demographic changes, enrollment, credentialing, contracting, and status inquiry. Additionally, it enables the health plan’s staff to review select requests to control quality.

Business Challenges:

• Increasing costs of provider administration
• Securing provider engagement with new payment and care models
• Regulatory pressure for transparency

Key Features:

• Step-by-step online provider self-service enrollment applications
• Automated provider re-credentialing reminders and online credentialing data refresh
• Secure online provider contract presentation and acceptance
• Provider self-administration of demographic data
• Workflow/rules-driven review of provider-submitted data
• Configurable provider scorecards and quality information

Key Benefits:

• Increased provider satisfaction due to ease of use of online provider portal
• Reduces data administration costs associated with contracting, credentialing and re-credentialing activities
• Ensures data governance standards are adhered to with provider-submitted data