Current Network Management is largely being handled manually through homegrown applications. With the introduction of Insurance Market places, the dynamics of Network Management has dramatically changed. Year 2014 will bring in about 32 million new members and along with them increased use of Provider Services are expected. More Providers are expected to join Private Payers.
The Centers for Medicare & Medicaid Services proposed a new policy requiring payers to expand their networks to include 30 percent of essential community providers in their areas or risk being kicked out of the marketplaces.
- Lack of transparency and communication between the stakeholders limits provider satisfaction
- Manual process and slow time-to-market limits provider productivity within the network
- Retain existing provider network to support healthcare regulations and compliance guidelines
- Visibility in end-to-end contracting process
- Need for system-driven streamlined provider contracting process
- Lack of centralized system of records for provider servicing
Provider Onboarding is a BPM enabled solution from Tech Mahindra that allows healthcare payers to automate this critical business process;
Helps slashing onboarding timelines, administrative expenses and minimizing healthcare fraud
Our Capability in delivering the quality enhanced Provider Onboarding Solution includes
- In-depth understanding of the provider onboarding process
- Experience in handling Data Sensitive regulatory projects
- Rich technology competencies
- Develop customizable business rules
- Help quickly adapt to regulatory changes
Our Value proposition
- Measurable reductions of cost and slashes onboarding time by 30% of usual time
- Expand provider networks by enabling the business process automation
- Eliminate data redundancy and human dependency
- Phase-wise execution approach with end-to end process visibility
- Unified point-to-point integration with internal and external interfaces
We are helping a large West coast based US Healthcare Payer to accelerate rules driven, process enabled Network Management, on the road to reduce healthcare fraud and certification errors through centralized credentialing and licensing.