Attentis

Anonymous

Provider Network Management

The Background

Our client operated their Provider Network Management (PNM) processes entirely through spreadsheets, lacking a centralized system for tracking and management. This led to inefficiencies, disjointed workflows, and difficulty in ensuring provider credentials were up to date. Recognizing the need for a comprehensive solution, they partnered with Attentis Consulting to modernize their PNM operations.

The Challenge

The primary challenges our client faced included manual, spreadsheet-based PNM processes with no centralized tracking system, disparate teams, people, and systems leading to inefficiencies and lack of coordination, difficulty in tracking provider credentials and ensuring compliance, and limited visibility and automation in case escalation and provider management.

The Solution

Attentis Consulting collaborated closely with our client to implement a comprehensive Salesforce solution using Health Cloud with the OmniStudio Managed Package. The project focused on increasing efficiency and introducing a provider self-service portal. Key aspects of the solution included automated case escalation rules to streamline workflows and improve response times, implementation of a provider self-service portal for streamlined interactions and updates, centralized tracking and management of credentialed providers, ensuring compliance and accuracy, and ongoing administration tools for efficient network management and compliance monitoring.

The Benefits

The project’s impact was significant: increased efficiency through automation, reducing manual efforts and improving response times, introduction of a provider self-service portal improved provider satisfaction and engagement, enhanced tracking and management of credentialed providers, ensuring compliance and accuracy, streamlined case escalation processes improved resolution times and customer satisfaction. Overall, the implementation brought a tremendous boost in operational efficiency and compliance for our client’s Provider Network Management.
  • Streamlined group sales processes, eliminating reliance on spreadsheets and emails.
  • Enhanced efficiency and accuracy in Medicare product management, improving overall performance.
  • Centralized platform for managing sales and service operations, leading to increased agility and scalability.
  • Improved customer engagement and satisfaction through personalized experiences across portals.
  • Simplified coordination across lines of business, resulting in a more cohesive and responsive organization.

Conclusion

Attentis Consulting’s Salesforce Health Cloud solution revolutionized our client’s Provider Network Management, addressing key challenges and bringing automation, efficiency, and compliance to their operations. By leveraging Health Cloud’s capabilities and our expertise in healthcare solutions, we empowered our client to modernize their PNM processes, improve provider engagement, and ensure ongoing compliance, setting the stage for continued success and growth in their network management operations.