Enroll Providers in a Network

With Health Cloud’s Provider Network Management, you can customize workflows that enable payers or provider groups to quickly segment and assess provider candidates. You can also help providers use the self-service application for streamlined enrollment.

• Register to Join a Payer Network
  Payers can reduce administrative burden by enabling prospective providers to self-register through the provider portal. As a provider, you can easily register in a payer network, complete an application, and provide your credentials and licenses.
• Nominate a Provider to Join a Payer Network
  As an existing provider or a non-registered provider, you can nominate another provider to the health plan using the provider portal. Make your job easier by using the embedded forms in the portal instead of expensive, inefficient legacy paper-driven processes.
• Register to Join a Payer Network With NPPES
  To further streamline the registration process, payers can now enable providers to use their unique 10-digit unique NPI number to pre-fill information for faster registration.
• Nominate a Provider to Join a Payer Network Using NPPES
  Providers can now nominate other providers to join the health plan using their NPI number or by searching with their demographic data. This search cross-references the NPPES directory and provides a list of results from which you can select and nominate a provider.
• Recruit a Registered or Nominated Provider to a Payer Network
  When a provider registers with the network or nominates a peer through the portal, Salesforce creates a lead record. As a recruiting specialist at the payer’s office, use the lead record to initiate a conversation with the provider, validate their information, and complete the recruitment process.
• Start the Provider Credentialing Process
  As a provider who is recruited into a provider network, you receive an email with instructions to log into the Provider Portal experience cloud site and start your credentialing application process. Enter information about your education, training, or practice standards, and professional qualifications (licenses, certifications, education, and registrations).
• Start the Primary Source Verification Process
  As a credentialing specialist at the payer’s office, verify your providers in days instead of weeks. After the provider completes the credentialing application, call them and verify the information in their application form, so you can certify or license the provider with a healthcare organization. Our process captures some competencies for the provider right from the recruiting phase, and saves time and cost while providing full transparency throughout the process.