Get to Know Provider Network Management

Recruiting providers and adding and managing them in provider group or payer network is a lengthy, time consuming process. And the manual nature of this process has always been a pain point in the industry. Optimizing this process is essential to increasing provider satisfaction rates and improving patient outcomes. That’s where Health Cloud comes in.

Health Cloud is a system of engagement for managing payers’ and providers’ networks and associated contracts. The results are improved access to care, patient experience, provider satisfaction rates, and operational efficiency. Provider Network Management in Health Cloud is an add-on product that simplifies provider enrollment and automates the management and association of provider networks and contracts.

Note Provider Network Management is available in Enterprise and Unlimited editions of Health Cloud provisioned with the Health Cloud Provider Network Management Add-On license.

With the help of compliant contracts and outcome-based networks, Provider Network Management:

• Strengthens provider relationships and increases provider satisfaction rates through a transparent network and contract management process.
• Helps build provider networks to maximize patient outcomes and ensure best care by accredited providers.
• Automates and optimizes the network and contract process using guided workflows.
• Reduces manual entry by retrieving provider information from the NPI registry.
• Generates the provider’s credentialing application form using DocuSign integration.
• In combination with Analytics, guides the recruitment specialist to identify the right provider for a given payer in a given region or location.
• Helps the Payer team run through all the steps of the recruitment, credentialing, network participation, and contracting by providing the right guidance at each step.
• Runs validations to ensure that the provider is given the correct contract.

Overall, Provider Network Management helps to quickly enable full contract, provider, and network setup.

• How Provider Network Management Works
  Provider Network Management in Health Cloud enables payers and provider groups to easily enroll providers, construct effective provider networks, and retain top healthcare talent. Provider Network Management streamlines provider enrollment and supports a range of contract types, network models, and provider relationships.
• Provider Enrollment
  Provider Network Management reduces provider onboarding time with an efficient registration, recruitment, credentialing, and verification experience. It also increases provider engagement and satisfaction, and improves payer operational efficiency.
• Provider Network Management Data Model
  The provider network management data model provides standard objects and record types for provider data. This data includes the provider application, credentialing, and contract payment terms.