Technology

Companies cannot support provider information and credentialing without great technology. For many managed care companies, the provider networks are the product they sell. Yet surprisingly, most companies maintain multiple legacy provider files for different functions – claim payment, credentialing, directories, regulatory reporting, referrals, mailings, sales proposals, etc. Often the provider information is redundant, incomplete, duplicated and generally inadequate resulting in major problems in claim payment, directories etc.

Companies need to develop a strategy for maintaining a single provider file. Legacy systems need to be supported by automated interfaces so there is a single source of record for any function.

We have outstanding experience developing innovative technology solutions to these problems.