There’s a good reason why many clinics and hospitals outsource their provider network management. The process of credentialing and onboarding new physicians can be tedious at times, averting the company’s attention from things that matter, which is providing elite service.

The biggest issue with the provider network management is the constant data updates. Whether you’re managing the provider network in-house or outsourcing the process, you’ll have to spend so much time making updates. As if that wasn’t enough, small mistakes can be costly, potentially putting your company on trial.

Despite all the obstacles, there are ways to simplify provider network management. In this article, we’ll talk about all the things you can do to make the process more straightforward.

1.    Find the right technology

For the most part, managing a provider network will be as efficient as the software and systems you’re using. With the right application, your medical institution can streamline and automate the onboarding process, significantly reducing associated costs. Even better, the software covers every step of the way, from credentialing to contracting.

Our suggestion is to always look for software that prioritizes interdepartmental collaboration. The system needs to work in real time so that you can make updates on the fly. Find a digital solution that offers fantastic chat functionality.

At the same time, it’s best to avoid software that doesn’t offer a high degree of integration. As you’ll likely have to connect the system with various data sources like CAQH and NPPES, you need a solution that can build upon your existing onboarding process. With integrations and API, you won’t have to hop on and off external platforms during the verification process.

Of course, all of this is irrelevant if you decide to hire an external provider. Top-tier CVOs, like Andros, have streamlined procedures and work under a “plug-and-play” principle, providing customized solutions for your medical business.

2.    Focus on implementation

Once you have your eyes set on specific software, it’s time to start the tedious implementation process. Even if there’s a streamlined method for implementing the solution, you’ll probably struggle a bit because of all the changes that you need to introduce. Luckily, the issue can be somewhat alleviated by getting your implementation partner acquainted with your methodology.

Make sure that your partner understands what kind of workflows you’re currently using and what type of workflows you wish to use in the future. Furthermore, explain to your partner what kind of technology and resources you’ve been using so far.

Most providers have a good knowledge of the popular workflows and solutions and what needs to be done during implementation. However, they will be oblivious to your specific requirements. As with any enterprise software implementation, the solution needs to be customized to your specific business needs.

3.    Customize workflows 

As mentioned, customization is crucial for getting the most from a provider network management system. The good thing is that you can collaborate with your staff to create a perfect workflow that would suit their needs. Creating a viable strategy and goals in advance is invaluable as it makes it easier to track the implementation progress.

Medical businesses often make a false presumption that new workflows should be introduced the same day they hire a software partner. This usually isn’t true, as you’ll likely make a lot of alterations along the way. Among others, credentialing and onboarding software is continuously changing, so you’ll have to change with it.

Medical software experts recommend that you go with MVP or a minimum-viable product. It will give you access to basic but customized workflows that you can use in the forthcoming period. Then, when the need arises, you can make alterations.

4.    Use reporting

Reporting is another aspect of provider network management that most businesses have trouble with. Due to the sheer number of data, the company’s management has to go through dozens of documents and sheets during the onboarding process and then present them in reports.

Ideally, you should be looking for a provider network management system that comes on a CRM platform. That way, you can ensure that the reporting focuses on the vital data and that it is performed in real-time. You need to ensure your providers have access to past credentialing, communication, and utilization reports to achieve the highest possible satisfaction.

Another good suggestion is to create a data team that will improve data collection and presentation. One of their main tasks would be to corroborate and organize data, a process when implementing new software and systems.

Among others, you need to ensure that providers can easily notify the software team about the data changes. There needs to be an open line of communication between the two groups so that the data team can update providers’ information when needed. As a result, you’ll get tidier, more precise provider network reports.

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Jasleen Bhatia works as a content writer for VCBay News. She is pursuing her final semester in Bachelor of Business Administration from IIPS, DAVV. Driven by her keen interest in entrepreneurship and finance, she writes business-related articles.


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