Cloud-based provider and network data management solution for managing complex provider relationships, networks, facilities and contracts with a flexible and scalable approach.
Healthcare organizations are faced with an everchanging and demanding regulatory environment that requires constant compliance updates and consistent processing. In addition, there are a growing number of complex associations between providers, doctors, groups, hospitals and insured members. Managing the accuracy and consistency of provider information, along with the provider information as it relates to each association or relationship, has become very challenging.
- Provides scalability and flexibility to create unlimited relationships between networks, providers, service locations and line of business
- Enhances productivity through access to a real-time single database of providers information and complex associations
- Utilizes a unique four tier system to create and manage complex and multiple relationships and multiple Lines of Business
- Allows viewing of information that is relevant for a particular provider type, e.g. facility vs. physician through its provider-type centric user interface
- Prevents duplicate Provider data entry based on NPI
- Has a built-in API call out and data upload from NPPES with the ability to verify provider status based on user defined time frames
- Allows for external Provider data upload with user visibility of data prior to upload completion
- Ability to link to multiple credentialing solutions and other core healthcare systems
- Assigned member management
- Ability to move a mass number of members at one time
- Automated system that forces the user to reassign members when terming a provider
- User interface with search features for available providers to receive reassigned members