Creating Unified Healthcare Solutions: Insights from Virsys12 and Conga on Integrated Provider Data Management and Contracting
In the rapidly evolving healthcare industry, the need for seamless provider data management and contracting processes has never been more critical. Healthcare organizations face significant challenges in managing provider data and contracts across multiple systems, leading to inefficiencies and lost opportunities to improve care delivery. In this Q&A, Tammy Hawes, Founder and CEO of Virsys12, […]
Provider Lifecycle Management: The Build vs. Buy Dilemma
When healthcare organizations look to implement a provider lifecycle management (PLM) system, they face a critical decision: should they build a custom solution from scratch or invest in a specialized solution from a vendor? A truly comprehensive PLM system—covering provider onboarding, credentialing workflows, contracting with fee schedules, claims activation, ongoing provider data management, and provider […]
Streamlining Provider Data Management & Directory with V12 Network
Accurate and efficient provider data management is critical to the success of any healthcare organization. Let’s face it, provider networks are complex. The need to maintain up-to-date, comprehensive directories has never been more critical. Yet, many organizations struggle with the intricacies of managing multiple provider data sources, keeping pace with regulatory requirements, and ensuring that […]
2026 REAL Act Countdown: Is Your Provider Data Ready to Make a Splash?
In the world of healthcare, change is the only constant. But the wave of transformation heading our way with the REAL Health Providers Act is more like a tsunami. Set to crash into the industry in 2026, this legislative behemoth is set to revolutionize how we manage provider data. The question is: will your organization ride […]
The Role of Technology in Transforming Network Operations
In the ever-evolving landscape of healthcare, provider network operations serve as the backbone of the provider lifecycle. Efficient management of these operations is critical, ensuring that the lifecycle continues seamlessly long after initial enrollment, onboarding, and credentialing are complete. Yet, the sheer complexity and volume of these tasks often result in operational bottlenecks that can […]
Maximizing ROI with Virsys12: Real Success Stories and Powerful Tools
In today’s fast-paced healthcare environment, efficiency and accuracy are crucial. At Virsys12, we are committed to providing solutions that not only streamline workflows but also deliver significant returns on investment. We are excited to highlight some of the remarkable successes our clients have achieved, introduce our powerful ROI Calculator, and share insights on the benefits […]
Key Takeaways on Combating Siloed Data in Healthcare
Efficient data exchange is crucial in today’s healthcare landscape, yet the industry grapples with siloed data—information trapped within different departments, systems, or organizations. This fragmentation hinders collaboration and optimal patient care. My recent article in Forbes, “Unraveling The Chaos: How Siloed Provider Directory Data Undermines Pricing Transparency,” takes a look at this issue. Here are […]
Q&A with Peter Schmidt, Virsys12 Chief Customer Officer
Navigating the Evolution of Provider Network Management: Q&A with Peter Schmidt, Virsys12 Chief Customer Officer (CCO) As a seasoned professional in the Provider Network Management (PNM) arena, Peter Schmidt sheds a light on the industry’s transformative journey and Virsys12’s pivotal role in shaping its trajectory. From your experience in the PNM space, what have been […]
The Role of Incorrect Provider Directories in Surprise Medical Billing
Imagine visiting a doctor you believe is covered by your insurance, only to later receive an unexpected, hefty bill. Sound familiar? You’ve fallen victim to surprise medical billing. And a significant culprit behind this issue is inaccurate provider directories. Surprise medical billing occurs when you visit a doctor you think is part of your insurance […]
Tackling the ‘Ghost Provider’ Dilemma: The Critical Need for Accurate Healthcare Directories
Have you come across the term “ghost provider”? A ghost provider is a healthcare professional listed in a health plan’s provider network but is not actively participating or accepting members under that plan. Often, these inaccuracies in provider directories arise due to the challenging and labor-intensive process required for both providers and payers to maintain […]
Unveiling the Critical Role of Provider Data in Health Plan Operations
In the dynamic landscape of healthcare, the accuracy and currency of provider data have become paramount for the survival of health plans. My recent article in Forbes, “The Data Behind The Provider Directory: Why Provider Data Is Key,” delves into this topic and the crucial role of provider data in optimizing workflows, ensuring precise claims […]
Q&A with Virsys12’s CTO, Seth Hobgood
What are you most excited to be working on this year at Virsys12? This year, a key focus for us is enhancing our V12 Provider Data Engine (PDE) product to tackle the challenge of ever-changing provider data in healthcare organizations. This application processes data from various provider data sources, including provider demographics, provider taxonomies and […]
Healthcare on Overdrive: Why an Enterprise Provider Data Strategy is a Must for Health Plans
In the ever-evolving landscape of healthcare, where labor costs intensify and regulatory complexities surround provider networks and directories, health plans find themselves at a crucial juncture. The need to reimagine their approach to working with providers has never been more apparent. Fragmented engagement, siloed data, and disparate systems are becoming obsolete and unmanageable. To navigate […]
Five Reasons Companies Struggle With CRM Implementations
Tammy Hawes, CEO, and Founder of Virsys12, explores the hurdles organizations face in successfully implementing CRM systems in her Forbes Technology Council article. While CRM systems offer the promise of improved customer relationships and streamlined processes, Hawes identifies five common reasons behind implementation struggles. These include insufficient executive support and employee buy-in, the temptation to […]
How to Build Better Behavioral Health Networks
Healthcare Business Today More than 50 million Americans live with or experience mental illness, according to Mental Health America. This leads to increased disability claims, missed experiences, premature death and even suicide. It’s a problem that needs a solution. Thankfully, recent legislation and federal investments have been made in pursuit of better support and resources […]
Why Provider Network Management Is Important For Health Plans
Before founding Virsys12, I started my career as a software developer in healthcare and ultimately held roles as a CTO and CIO. It was evident to me that there was room for improvement in the automation of business processes in healthcare to eliminate waste and improve efficiencies. We believe there is no better place to […]
How to Improve Patient Engagement for Healthcare System Success
If we truly want a healthcare system in America that’s both effective and efficient, we should focus on patient engagement, in which clinicians communicate clearly with patients and patients share in making decisions and managing their conditions. This means that providers must make the effort to get to know their patients, communicate honestly with them […]
Why We Should Embrace Digital Healthcare
It’s a truism that the pandemic dramatically sped up the digitizing of our lives, with the ubiquity of teleconferencing today being the most obvious manifestation of this trend. But that’s just the tip of the iceberg. Perhaps the most dramatic change has been the rise of digital healthcare–and this is good news for all of […]
How Building Behavioral Health Networks Can Help Solve the Mental Health Crisis
Almost one in five American adults live with a mental illness, up to 51.5 million people in 2019, according to Mental Health America. Depression is one of the leading causes of disability, and people with severe mental health diagnoses die two decades prematurely. The mental health crisis is even more dire for young adults in […]
Moving Enterprise Systems to the Cloud is Key in Eliminating Waste
According to a study published in JAMA, 20-25% of healthcare spending is wasteful, costing at least $760 billion per year. Administrative waste, the excess overhead that occurs primarily due to the complexities between providers and payers including time devoted to billing and reporting, is the largest area of waste and accounts for $266 billion a […]
Virsys12 + Becker’s Hospital Review Webinar
The success of payer-provider partnerships depends on a new level of collaboration. Keeping up with the expectations of members and patients regarding how they access, engage and experience healthcare requires a new type of partnership. At Virsys12, we believe clean, accurate provider data plays a critical role in transforming the business of healthcare. This webinar […]
Keep Your Providers in Network Happy
When it comes to building and managing a provider directory in healthcare, the provider network can be complicated, especially because it must be kept compliant and up to date. Your provider onboarding and credentialing team try their best to juggle it all, but it can be easy for them to fall short. This is largely […]
What ACOs Need to Know to Meet the Demands of ACO REACH and Unlock its Benefits
In an effort to lower healthcare costs and improve quality of care and access to care, the Centers for Medicare and Medicaid Services (CMS) Innovation Center recently cancelled the Geographic Direct Contracting Model and is phasing out the Global and Professional Direct Contracting Models (GPDC) at the end of 2022. Participants that meet requirements will […]
5 Ways Providers are Transforming the Patient Experience with Salesforce
5 Ways Providers are Transforming the Patient Experience with Salesforce Health Cloud The widening affordability gap and the rise in high-deductible health plans have pushed patients to assume more responsibility for their medical costs. With this additional responsibility, consumers have taken a more active role in their clinical journey. Patients are paying more for care […]
Virsys12 + ProviderTrust Webinar
Executive leadership from ProviderTrust and Virsys12 discuss managing the complexities of provider data and network management for providers and payers. From onboarding and recruiting to contract negotiations to setup of reimbursement models for claims payments, we explore the challenges that face payers and providers across the provider lifecycle and how best to manage in 2022 […]
Accelerating Healthcare Innovation With Cloud Data Analytics
Accelerating Healthcare Innovation With Cloud Data Analytics Cloud technology, machine learning, and in-depth analytics across the healthcare industry are redefining patient care, patient experience, provider experience, and innovation. Learn about the latest trends in healthcare cloud solutions and analytics and how they’re fueling the next wave of healthcare innovation. 3 Ways Cloud Computing Will Redefine […]
Improve Claims Payment Integrity and Reduce Provider Burnout
Why Is Accurate Provider Claims Payment Difficult for Healthcare Payers? Claims processing for payers is a complex process with combination of value based and fee for service models, market expansions, and acquisitions. This process also often requires multiple disparate systems. After layering on the constant changes to provider data and the process to onboard, credential, […]
How Healthcare Companies are Taking Advantage of Intelligent Automation
Healthcare Companies are Taking Advantage of Intelligent Automation One thing that healthcare has an abundance of is required forms to be completed… tons of forms. It seems as though every time you go to the doctor, they ask you to fill out the same stack of forms again and again and again. Salesforce recently announced […]
Get More From Digital Engagement in Healthcare
Is Digital 360 worth the hype? The short answer is “absolutely”. Virsys12 has been in the Salesforce ecosystem for nearly 10 years, and during that time we’ve completed almost 1,000 projects focused primarily on the healthcare industry. Our clients are always looking for better ways to keep healthcare consumers engaged and up to date. From […]
Complex Relationships with Providers in Healthcare
Healthcare organizations have complex relationships with their providers and there are solutions to help with tracking all the steps in Provider Lifecycle Management. Cloud-based technology like Salesforce is available to automate the process of onboarding providers, streamline documentation associated with credentialing and contracting. Salesforce is the digital solution every healthcare organization needs for more productive […]
