The Enterprise System Provider Management Suite enables payers to dramatically reduce the contracting and credentialing burden on providers and their own staff while streamlining the administration of provider data, including fee and reimbursement schedules.
The Provider Management Suite’s comprehensive functionality includes:
- Automation of many steps of contracting and credentialing
- Flexibility to manage many different reimbursement models
- Paperless environment that allows for real-time information storage and electronic document sharing
- Geographic mapping and geo-coding, enabling you to view coverage areas and provider statistics
- Management of provider data, including provider information, payees and tax IDs
- Ability to launch and monitor network-building campaigns that drive providers to a web portal
In addition, the Provider Credentialing Portal and Provider Contracting Portal allow providers to enter information on their own, automating document tracking and minimizing data entry for your provider services staff. 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 in order to save time and reduce data entry errors.
Choose From a Full Spectrum of Features
With the Enterprise System Provider Management Suite, you can continue to use the features in your existing system that work well for you. Choose the Provider Management functionality that you need, and we will work with you to integrate seamlessly with your existing system.
Provider Credentialing Portal
Automate your processes with the Provider Credentialing Portal, which allows providers who are due for initial credentialing or re-credentialing to submit information and documents electronically. The 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 and then automatically uploaded and stored in the system for instant online access.
Your provider services staff receives automated notifications when providers submit credentialing information. The information can be easily exported to your existing internal systems or imported directly into the Enterprise System.
Provider Contracting Portal
Automate your processes with the Provider Contracting portal, which enables providers interested in joining your network to submit demographic and contact information, practice location details and W-9 information. They can also review fee schedules and contract details, and then digitally sign and submit their contract data. The system automatically adjusts the contract language presented to each provider based on a provider’s specialty, zip code, Medicaid participation, or nearly any other variable.
Your contracting staff receives automated notifications when providers complete and submit online contracts. The contract information can be easily exported to your existing internal systems or imported directly into the Enterprise System.