How Payers and Health Plans Optimize Performance with Provider Lifecycle Management

How Payers and Health Plans Optimize Performance with Provider Lifecycle Management

Finding a complete provider lifecycle management system, as a payer, involves not only the right technology but also dedicating the right resources to the performance of the network for provider outreach and onboarding, credentialing, contracting and ongoing data maintenance for the provider directories. By using a Provider Lifecycle Management (PLM) solution, your organization can better track complex provider relationships, demographics, and payment terms to optimize your provider network. PLM solutions also give your organization the ability to  better serve members and impact the bottom line. This article explains:

–  What is provider lifecycle management (PLM) system?

 – The benefits of and enterprise PLM system

 – Robust processes and systems to support PLM

What is a Provider Lifecycle Management (PLM) system?

Using a Provider Lifecycle Management system is an effective way for health plans and payers to follow the providers journey through the process of onboarding, credentialing and contracting. Implementing an automated PLM solution results in many benefits for cost saving and overall efficiency for the organization. The use of enterprise technology is the best support for a collaborative process for providers, practitioners and your internal department collaboration. By modernizing provider experience with a unified platform for a provider network management solution, healthcare organizations can grow their provider networks, improve physician satisfaction, and ultimately deliver better care to patients and members.

The Benefits of Provider Lifecycle Management

There are many benefits and reasons why Provider Lifecycle Management is important for payers. We have compiled a list of what we consider to be the top 3 benefits your organization could expect to gain by utilizing a PLM system. 

Benefit #1: Visibility of the Provider Network in “Real-Time”

Knowing what providers are “in-network” in real-time is key to meeting new government mandates for provider directory data. Health plans no longer have the luxury of a 30, 60, or 90 day turn-around on provider demographic data updates. With the use of an enterprise PLM system and a provider portal, your organization can give real-time access to the providers in the network to self-serve and contribute to their credentialing information, practicing locations, taxonomy and specialty, and other critical information necessary to ensure an accurate provider directory.

Benefit #2: Streamline Processes and a Single Source of Truth

In order to remain competitive and compliant with CMS mandates, it is crucial for your organization to keep their provider records current and accurate, and there is no better way to ensure a streamlined process than to implement an enterprise PLM solution that providers a 360-degree view of providers in the networks, but also allows departments to seamlessly communicate with each other and providers and practitioners using the same “source of truth”. Gone are the days when your organization can have different siloed systems and manual processes, faxes, emails, excel spreadsheets and paper documents shared between departments and providers to manage your networks. The easiest way to stay up-to-date is to keep everything digital and utilize a single-platform solution. 

Benefit #3: Better User Experience and Provider Engagement

By creating a cloud based platform where both your employees and the providers they serve can collaborate, you ensure quick access to provider and practitioner directories and credentialing. This allows users the functionality they need to get their job done faster and easier. Having an automated workflow without manual intervention eliminates the need for data entry all together in many regards, and implementing an enterprise PLM solution creates a platform to view changes in real-time. Who wouldn’t love that!

Robust Processes and Systems to Support Provider Lifecycle Management

Virsys12 can reduce the administrative burden related to Provider Lifecycle Management including Provider Applications, Onboarding, Provider Network Management, Credentialing, and Contracting with Fee Schedules utilizing our transformational applications, V12 Network and V12 PDE (“Provider Data Engine”). These AppExchange managed package applications are built on Salesforce Health Cloud ensuring that all security, compliance, disaster coverage and scalability are met and backed by Salesforce. Why not start your journey to improve your ROI and delight your employees and providers with a 360-degree view of your provider organizations, their practitioners, and the networks they serve. 

Do you have the technology you need to manage your providers and provider networks?

Get in touch with us to discuss how Salesforce and our V12 Network and V12 PDE “Provider Data Engine” works with Salesforce Digital 360 to provide an unparalleled level of provider experience and efficiencies.

About the Author

About the Author

Tammy Hawes is CEO and Founder of Virsys12, a Healthcare Focused Salesforce AppExchange and Consulting Partner. Hawes launched Virsys12 in 2011, with a track record of more than 25 years of executive success.

About the Author