Increased pressure on health plans to control healthcare costs and maintain quality is translating into a need for greater visibility into provider service delivery and member experience. The evolution towards consumerism is also driving a push for increased transparency of actionable provider information to members. Such trends have made the management of the provider relationship lifecycle a strategic imperative.
Portico PNO Addresses the Provider Network Evolution
Portico PNO is an enterprise-class software solution that enables health plans to evolve provider network operations into a corporate asset. It combines a rich set of functionality for automating network management processes with metrics-driven workflow capabilities that promote operational visibility.
Portico PNO empowers health plans to manage their end-to-end provider relationship lifecycle by optimizing various network operations functions including provider recruiting, credentialing, contracting, enrollment, servicing, and provider selection for claims adjudication. The Portico PNO solution is comprised of Provider Manager, a workflow driven-application to support network operations functions; PNO Gateway, a high performance engine for provider selection, as well as the exchange of provider information; and Portico Foundation, a services-oriented provider relationship repository.
Portico PNO delivers powerful benefits, including:
- Increased adjudication first-pass rate and reduction in processing errors
- Minimized cost of change and accelerated time to market
- Greater availability of accurate provider information
- Improved staff efficiency and reduced training costs
- Lowered data administration costs
- Expanded network planning and decision support
- Enhanced provider satisfaction
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