The Enterprise System Provider Management Suite is designed to simplify the administration of provider and clinic location information, fee schedules, and reimbursement schedules, as well as dramatically improve the efficiency of your provider contracting and credentialing efforts. The features and web portals included in this product suite can be used individually or together as a fully integrated provider management system.
Self-service web portals allow providers to enter contracting and credentialing information on their own, automating document tracking and simplifying manual data entry tasks for your provider services staff. “Smart” features built into the portals automatically adjust the information presented online, based on the provider’s specialty, zip code, practice location, or other variable. Providers are required to complete only information that is pertinent and applicable to them – saving time and minimizing data entry errors.
Features & Benefits
Use any or all of the following Provider Management Suite options, depending on your needs:
- Enterprise System Provider Contracting and Provider Reimbursement features
- Enterprise System Provider Contracting and Provider Credentialing features
- Provider Contracting web portal
- Provider Credentialing web portal
Go paperless with web portals
Eliminate faxing, squinting over hand-written applications, and waiting for important documents to make their way through the postal service. Provider Contracting and Provider Credentialing web portals allow providers to complete a network application, attach supporting documents, and then submit the information within minutes. The transmitted information can be easily exported to your existing internal systems or imported directly into the Enterprise System.
Automate the provider contracting process
Give providers who want to join your networks access to the Provider Contracting web portal, where they can fill in demographic and contact information, practice location details, and W-9 information; review fee schedules and contract details; and then digitally sign and submit their contract data. The contract presented to a provider can vary, based on the provider’s specialty, fee schedule, practice location, or other variable.
Automate the provider credentialing process
Give providers (due for initial credentialing or for re-credentialing) access to a web portal, where they can submit required information and supporting documents electronically. The Provider Credentialing web portal leads providers step-by-step through the NCQA standards for credentialing requirements. Supporting documents, such as resumes, copies of licenses and professional degrees, board certifications, proof of malpractice insurance, or any other electronic documents, can be attached as part of the credentialing process, and then automatically uploaded and stored in the system for instant online access.
Streamline provider management processes
The Enterprise System Provider Management Suite also allows you to:
- Send automated notifications to your contracting staff when providers register and complete and submit online contracts or credentialing information.
- Launch network-building campaigns that drive interested providers to a web portal, where they can complete online applications, digitally sign contracts, and attach electronic documents.
- Automatically adjust the contract language presented to each provider based on a provider’s specialty, zip code, Medicaid participation, or nearly any other variable.
- Monitor the effectiveness of provider recruitment campaigns.
- Send data collected through web portals to your existing internal systems or directly to the Enterprise System.
- Efficiently credential and re-credential providers who participate in your networks based on NCQA guidelines.