3 Provider Enrollment Methods that Reduce Risk and Save Time and Money

The more smoothly you can onboard providers, the more it expedites the provider enrollment process. And the faster you can onboard providers, the faster you can get them enrolled with payers. The onboarding process relies on the collection and verification of hundreds of data elements for each provider, which is a challenge. By expediting this process, you can save time and money and improve provider satisfaction.

VerityStream’s platform includes tools that import provider data from various sources to reduce the challenges that come with provider data collection. One notable example is the way that providers use VerityStream’s Claim Your Profile tool to import data from CAQH into their profiles into the platform. Also, by using VerityStream’s Apply provider-facing portal, providers can access their profile, add and edit their own information, upload documents and images, and electronically sign forms.

A core component of the workflow required for provider enrollment is the completion of laborious, data-filled applications. The ability to pre-populate those applications can expedite the provider enrollment process by reducing errors, eliminating duplicate data entry, and reducing the time spent searching for information. Avoiding these inefficiencies can reduce payer rejections of applications due to incorrect data or a lack of information on the application. One of the clearest ROIs associated with pre-populating applications through VerityStream's Enroll tool is that it allows you to complete forms in seconds or minutes instead of hours.

VerityStream's Enroll tool makes it easy to search a library of over 5,000 pre-formatted applications and select forms to be automatically populated. Enroll pulls the information required for specific applications from the VerityStream database and inserts the data into the correct fields on the forms. With Enroll, what used to take hours now takes minutes. Beyond that, Enroll’s InForm tool allows you to automatically populate online forms, such as PECOS, with provider data.

Before, during, and after completing provider enrollment applications, there are a tremendous number of tasks that occur in conjunction with the application process. You have to keep up with workflows and manage processes, reminders, letters, data exports, and PSVs. Using provider enrollment automation tools for medical groups can save you significant time and introduce efficiencies that positively impact your entire process.

CredentialStream serves as both a fact-finding and risk mitigation tool. It integrates with over 1,500 primary sources and runs scheduled checks to pull validated data back into the system. It finds information, such as medical license expiration dates, updates them in the system, and shows that the system user has checked the information. Validate can verify information and also identify if providers have been disbarred from certain programs or if there are sanctions against him or her. If you automate PSVs, you will save the time that the manual processes would take and eliminate risk by collecting accurate information that reveals if the provider has negative marks on their record.