Healthcare payers work with providers closely to ensure members get appropriate treatment at the right cost. Provider network management encompasses a wide variety of components, from checking if the provider is in-network for members or managing pricing for a given clinical procedure. Healthcare provider network management helps the payers with the accurate provider’s data, which is received, verified, and continuously updated by the payer companies. OSP can engineer the next-gen healthcare provider network management system to help with accurate provider’s data and accuracy. Improved relationships with providers, increased member satisfaction due to coverage, and cost transparency is the top benefits of our provider network management software. Team OSP strives to build advanced provider network management software solutions that eliminate the risk of fines and increase ratings from government regulatory agencies.
The common bottlenecks which might slow down your business growth
Diverse contracts between healthcare systems, practitioners, etc. that increase complexity toward alignment.
Inability to maintain required regulatory compliance and avoid government fines.
Inaccurate cost predictability affecting the overall revenue cycle management.
Lack of standardized data management strategies to manage provider's data.
Inability to manage process workflow seamlessly for seamless provider network management.
Manual provider information management workflow affecting the quality of data accuracy and reconciling inconsistencies.
A systematic solution to gain comprehensive control to manage your provider network.
There is increased pressure on health plans to improve the efficiency of provider network management and seamless provider contracting to lower the care costs and make healthcare more accessible. Custom-made provider network management helps in measuring and improving the provider’s performance and redefining networking procedures to focus the value of their healthcare service.
OSP’ custom provider network management software strives to eliminate redundant and manual provider data management, medical credentialing services, provider contracting and profiling systems through highly advanced provider network management automation. We tailor provider network management software solutions to enable an in-depth analysis to monitor provider performance against set benchmarks with real-time alerts to notify the major changes in provider performance. Our automated provider network management solutions are customized to perform an in-depth analysis of existing networks and assisting in the creation. To enable new and multi-tiered pricing structures with aligning contracts, fee schedules and data, team OSP can engineer advanced provider management solutions on payer demands.
With multiple users connected to the provider network system, workflow management becomes highly essential to reap the benefits of qualitative provider network management. Advanced network software solutions are built on leading enterprise platforms that enable organizations to manage multi-departmental process workflows and complex provider data structures in diverse settings.
We customize medical network management as per the payer settings with built-in Smart Business Rules, provider document checklists, Intelligent case routing, pre-defined state-based Rules, and many other capabilities. Intelligent workflow management significantly improves operational efficiencies for provider and network management organizations. With lean and six-sigma-based provider data management software helps to eliminate repetitive processes resulting in reduced FTE requirements and significant savings on operations costs.
Automated provider data management is one of the most essential components in provider network management. An integrated provider data platform helps to streamline the key functions of a provider profile lifecycle by configuring seamless process workflows, SLA tracking, and intuitive dashboards. Our healthcare provider network management strives to enhance the accuracy of the provider’s data and eliminate data redundancy through cloud-based data management solutions.
Health plans struggle to keep their provider data updated and accurate to offer their members an optimal care experience. Our healthcare provider network management system is customized to provide you multiple benefits by building a single source of provider’s data. We ensure expedited provider onboarding, proper credentialing, network management innovation, optimized cost of operations, simplified HIPAA compliance and many more.
Coordination plays a vital role in developing quality provider network development and management; especially in the credentialing and contracting process with the need to quickly evolve the provider networks. To provide the top-notch provider data management system, we focus on optimizing the process workflows of recruiting, credentialing, and contracting through the customized enterprise-based provider network platform.
Our team can program medical network management software solutions for diverse Healthcare-specific data models and workflows for diverse health plans to efficiently operate complex provider touchpoints and relationships. Our custom-made provider management software help aligns complex provider data hierarchies and relationships by helping providers to offer quick and quality services. Our tailored provider network management help reduce onboarding time through streamlined recruiting, Healthcare credentialing and contracting processes.
Complex regulatory compliance needs, modern care delivery models and complicated provider network needs an automated provider data management with advanced provider contracting solutions. Financial penalties, non-compliance, and lack of coordination in the provider network impact the quality of member care. To ensure care transparency and uninterrupted care delivery to the members, a good quality provider contract management is needed.
OSP’ can customize provider data management software includes provider contract management with a centralized contract management system with the fast-tracking process. We help you automate and control contract creation as per the business needs. With relevant templates for contract initiation, contract negotiation, reviewing & approval, achieving contracts can be easily handled.
We help payer companies with highly regulated and role-based access to Medical credentialing documents in an organized way. With our provider network management software solutions, you can retrieve provider data and documents from CAQH & other credentialing systems. OSP can customize provider credentialing as per your needs to simplify capturing and storing provider contract documents such as provider agreements, current insurance & license proofs.
Credentialing makes it easy to collect, store, monitor and organize credentialing data by year to month and the present in easy-to-access tabs. The solution can be tailored to automatically generate notifications when documents are outdated or missing to request the necessary information. The tasks of managing expiration dates, practice locations, and auditing materials to verify current documentation are solved through automated credentialing.
A Texas-based mental health center wanted to reinvent the medical billing process and enhance approval rates which were 10% against 100 claims submitted.
It was challenging to manage multiple insurance providers for a large clinic set up for a health specialty that needs flexibility in billing, workflow automation, accurate claim scrubbing, and fill regulatory compliance gap.
The solution comes with-
Through a customized, robust solution, OSP reinvented the organization’s medical billing process and substantially enhanced approval rates, which were originally at a staggering 10% against 100 claims submitted.
How we do it
OSP created a tailor-made solution to maintain varied insurance providers within a large clinic set up with features such as billing flexibility, workflow automation, accurate claim scrubbing, and regulatory compliance.
How we do it
An advanced web-based claim scrubber was created to increase claim accuracy for an organization with a database of hundreds of billing and coding requirements. The solution automatically generated detailed reports to prevent future billing errors.
How we do it
To assist an organization with managing its provider network system, we created an efficient electronic solution to enter procedure codes, modifiers, and bundled codes, along with a comprehensive list of CPT and ICD-10 codes.
How we do it
To solve the challenge of increased administrative requirements and the rising number of new patients, our provider network management software solutions are customized for better provider performance management. Through operational transformation and advanced performance analytics, we help boost the quality of care at reduced costs. OSP' tailored provider network management solutions include benchmarking performance metrics and analytics to assess margin improvement and clinical effectiveness.
With our made-to-order provider management solutions, you can gain access to intuitive dashboards to have a clear picture of the healthcare provider's most critical cases, performance reports, work items, and other insights. The role-based dashboards can be customized in the provider data management systems to streamline the key functions of the provider lifecycle. Our systems can help to integrate robust workflows, SLA tracking abilities to monitor and manage the provider data with increased efficiency.
Integrated provider directory with advanced provider profiling is available in OSP' custom provider data management system. Our medical network management software can help you to quickly and easily search for the right providers, hospitals, radiology centers, and labs with side-by-side comparisons. We ensure data integrity with regularly updated data with established standardization and geocoding procedures. OSP' customized provider management software help to build member trust and loyalty and reduce member inquiries while enhancing their confidence.
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