Provider Enrollment

Digitize Provider Registration and Nomination

Enable payers, provider groups, and providers to seamlessly handle the registration and nomination process for joining a network using a self-service provider portal site.

Payers set up and manage recruitment campaigns to increase outreach, attract providers across lines of business to register to the network, and streamline provider leads.

Health Cloud helps payer and provider groups easily set up campaigns and create a self-service Provider Portal experience cloud site. Providers can then self-register or nominate peer providers on this portal with a digital registration form. When the provider registration or nomination process completes, a lead record generates for the payer recruiting team, to initiate recruitment.

Scale Provider Recruitment

Help recruiting specialists at the payer’s office optimize the recruitment process by segmenting and assessing registered or nominated provider candidates quickly and accurately.

Provider recruitment involves assessing providers of all types for inclusion in a network. With Health Cloud, payer recruiting teams initiate a recruitment workflow and review the leads of registered or nominated providers based on high-priority network needs. The built-in integration with the National Provider Identifier (NPI) registry helps recruitment specialists easily retrieve information from the provider’s NPI profile.

When the recruitment process completes, the recruitment workflow creates a Provider Portal login for the provider. Providers can then easily log into the provider portal to complete their credentialing application form.

Streamline the Provider Credentialing Process

Enable providers to use the self-service Provider Portal site to complete the credentialing process and ensure they meet a certain set of standards to join the payer’s network.

Credentials represent the professional qualifications required by providers to advise and treat patients. Credentials broadly encompass all the licenses, certifications, education, practice standards, and registrations a provider is required to have. Each provider network can customize their exact credentialing requirements.

The credentialing process is considered one of the biggest bottlenecks in provider enrollment. However, Health Cloud helps payer, provider groups, and providers to efficiently handle credential data using the self-service application. Health Cloud captures all aspects of provider education, work history, regulatory action, malpractice insurance, specialty, and board certification to allow for a thorough credentialing process.

Health Cloud’s provider credentialing process:

• Enables credentialing specialists at the payer’s office to digitize the process and easily customize the provider application content to meet the needs of their organization. It also captures provider applications with integrated credential verification and validation rules for mandatory information.
• Enables providers to be a part of the practitioner panel of the payer’s network by filling their professional information in the Provider Portal site. The digitization and built-in integrations with NPI for validation minimizes manual data entry and shortens the enrollment and onboarding time.
• Generates the provider’s credentialing application form by facilitating the integration with DocuSign.

Provide a Guided Provider Verification Experience

Help credentialing specialists ensure that providers have given up-to-date credentialing data by performing an on-call verification of the details.

The Health Cloud verification flow captures all aspects of provider information such as education, work history, regulatory action, malpractice insurance, specialty, board certification, to allow for a thorough verification. During the on-call verification, credentialing specialists can update the provider’s information and regenerate the credentialing application form. By giving consent and signing the DocuSign application form, providers agree to become a part of the payer’s network and payers initiate subsequent processes to define the contract.