Provider Credentialing & Provider Enrollment Case Management Solutions

Better way to manage Provider Credentialing, Provider Enrollment, and OnBoarding

Naviant offers world-class Health Payer Provider Enrollment Case Management Solutions to help health payers manage the Provider Credentialing process more effectively and with a higher degree of accuracy than the manual process most companies currently use today. By using a more efficient tool to manage the provider credentialing process, health insurers spend less time on administrative tasks.

Provider enrollment, credentialing, and onboarding is a complex process that can run dangerously close to the 60 day Medicare-based limit. Traditionally, the solution for a payer is to add labor hours to increase capacity. This approach can increase capacity but does nothing to simplify the complexity of the process. Simply adding staff also does not provide the payer visibility into the process.

How are the managers of the provider enrollment department able to verify the oldest applications are being worked first? How are workloads balanced? Is there enough visibility to know in advance what needs to be done to reach goals and deadlines? Lack of visibility into the provider enrollment process can hamper healthcare payers using a manual process.

Naviant’s Provider Enrollment Solution, powered by the OnBase Case Management enterprise information platform, solves both the efficiency and the visibility issues that have plagued the provide enrollment process. OnBase captures and stores the documents related to the provider contract including the provider agreement and proof of current insurance for the provider and medical licenses, organizes the information by year, and presents provider credentialing information in easy-to-view, easy-to-access tabs. This solution also manages expiration dates, practice locations, and more. This makes it easy to audit materials to verify whether or not current documentation is on file.  When documents are missing, OnBase automatically generates notifications via email, fax, or printed letter to request required information, while timers automatically remind the Credentialing department to follow-up if information is not received within a certain time frame.

With the OnBase Insurance Solution for Provider Credentialing Management and Naviant’s experienced team of implementation staff, support staff, and consultants, health insurers use fewer resources to manage the provider credentialing process which allows insurers to focus on higher value tasks, such as fostering provider relationships.