Healthcare organizations that build and manage complex provider networks need real-time, accurate provider data and efficient and automated processes to meet regulatory requirements and to better engage with their providers. V12 Network, built on Salesforce Health Cloud, is a Provider Lifecycle Management solution that automates and streamlines the process of onboarding, credentialing, and contracting in a robust enterprise solution. Unlike legacy application or custom software, V12 Network provides built in provider data checks and ongoing exclusion monitoring through our partnership and APIs to CAQH and ProviderTrust and helps health plans and health systems maintain and V12 PDE monitors changes in the provider’s data to alert you in real-time and help your organization update provider data real-time to ensure the most accurate and up to date provider directory data.
A Provider Lifecycle Management solution helps health plans and health systems maintain and organize provider data real-time to ensure the most accurate and up to date provider directory data. In today’s world the use of cloud based platforms and AI provide automation and eliminate costly mistakes and manual effort. As provider networks become more complex with value based care models, specialty networks, virtual care and home care networks, it is more important than every to track and have access to all credentialing, contracting and payment term information on your providers real-time. Provider attestment is now an obsolete concept as it relates to meeting provider directory requirements. Monitoring provider data changes in real-time is the new normal.
Provider data is complex and is a core reason that we originally created the V12 PDE application as an AI engine that continually monitors provider data sources and alerts your organization to provider data changes. Provider data that is identified as changed and pushed into V12 Network as a provider data case that can be assigned and worked by your team or the system can be configured to automatically update the provider data and alert. It is all up to your organization’s unique workflow and how you configure the product.
At Virsys12, we believe that a robust provider data management solution paves the way for a truly integrated platform for connected workflow automation. Our V12 Network application continues to evolve to support the one-to-many and many-to-many relationships within the most complex provider hierarchy.
V12 PDE ranks data changes based on:
Data Age
Source System Truth
Completeness of Data
Data Derivation
Data Consensus
Detail Significance
Provider network data is complex and is a core reason that we originally created the V12 Network application on the Salesforce Health Cloud platform. At Virsys12, we believe that a robust provider network management solution paves the way for a truly integrated platform for connected workflow automation that uniquely creates value for our clients. Our V12 Network application supports the one-to-many and many-to-many relationships within the most complex healthcare payer and provider data models and supports the complex provider payment models and methodologies emerging today.
V12 Network Supports:
Complex Account Hierarchy and Payer/Provider Relationship Management
Market/Health Plan/Network Specific Segmentation and Configuration Capabilities
Provider Demographics Tracking and Interfaces, Hospital Affiliation, Practice Location, Physical and Billing Facility Site by Practitioner
Provider Credentials Including Board Certifications, Accreditations, Medical Licensure, Education, Insurance
Automated interfaces to CAQH ProView Data and ProviderTrust OIG Exclusion Data
Automated interfaces to USPS for address verification
Integration with Conga and Aptus Contract Management Systems
Complex Billing/Physical Tax ID & NPI Hierarchy Combination Management via the V12 Navigator Tool
Practitioner Tracking by Agreement Including Specialty, Taxonomy, Network, Par/Non-Par Effective Dates
Provider Panel Status Tracking and Monitoring
Network Contract Generation with Fee For Service and Value Based Care Participation Payment Methodologies
Mass Updates of Providers by Network, Tax Id, NPI, Practicing Location using the V12 Practitioner Manager Tool
Optional lnterface of Provider Data Activation and Updates to Claims Systems
Virsys12 Salesforce consultants help you build your network using a scalable and powerful software platform, expand to new markets and add new networks with confidence and success. Get strong insights you can show and display to help promote your organization.
V12 Network can be implemented in record time. This Provider Network Management software displays integrated trends and comparative data for improved decision-making used to manage your network. It has secure; HIPAA-compliant access and reporting feature that make a positive impact on your organization and your team.
V12 Network includes:
Provider Outreach & Development
State agency, Employer, Member Entity Outreach and Development
Provider Onboarding, Credentialing and Fee Schedule/Payment Methodology setup
Electronic Network Contracting with stages (merging in payment terms)
Integration to CAQH, OIG, and State registries, and your claims system
Member Attributions List (with Health Cloud)
Member Engagement Campaign (with Marketing Cloud)
Integration with internal systems and Analytics (with Mulesoft and Einstein and Tableau)
Imagine a world where provider specific workflows are in sync with a single provider source of truth, all on the same platform. Sound far-fetched? Not with the V12 Network and V12 PDE application! From initial provider outreach and network development, to credentialing and contract/fee schedule management, and integration into the claims system (including on-going data management) our applications ensures that your organization maintains a 360-degree view of both provider data and critical workflows as practitioners and provider groups join the network and continues their relationship with your organization to serve your members and patients.
The Power of the Salesforce Platform
We understand that provider network management and the associated workflows can be complex. Our V12 Network application offers both pre-built workflow automation, as well as, declarative Salesforce workflow automation capabilities using Salesforce Health Cloud. So, no matter what your workflow requirements are, we have you covered!
V12 Network Workflows Include:
Provider Outreach & Network Development
State Agency, Employer, Payer/Provider Outreach & Development
Provider Network Enrollment & Application Management
In-House, Delegated & CVO Based Credentialing Management
In-Patient/Out-Patient Fee Schedule & Value Based Care Payment Methodology Setup
Electronic Network Contracting with Stages & Payment Term Merge Capabilities
Member to PCP Attribution Tracking
Physician Liaison Management & Provider Network Maintenance
Advanced Provider Search Capabilities
At Virsys12, we believe in the power of partnership. As such, our team has diligently worked over the last 10 years to evaluate and determine best-in-class third-party applications that compliment our solution set. The by-product of this work resulted in the creation of several pre-built integrations to some of the most popular third-party applications available. These pre-built integrations allow quicker time to value and reduce “swivel-chairing” between key third-party applications used throughout the provider lifecycle.
Key Pre-Built Application Interfaces Include:
CAQH ProView
ProviderTrust Federal Exclusions Search (OIG-LEIE, SAM), State Exclusions Search (All, 42 currently available), NPI Active Status, Medicare Opt-Out, Preclusion List
ProviderTrust Primary Source Verification (State license boards, DEA Registration, Board Certifications, CLIA, NPDB)
USPS Address Database
NPPES (Available in the V12 Provider Data Engine Application)
Conga Contract Lifecycle Management Application (CLM)
Google Location API (Provider Geolocation Capabilities)
Custom API-based integrations and ongoing data file transfers are also available in the V12 Network application through the Salesforce platform API. Common additional integrations include: EMRs/Practice Management Systems, Referral Management Systems, Claims/Adjudication Systems, Provider Directory Applications, Electronic Data Warehouses, etc.
With V12 Network, you will ...
Implement Results in as Quickly as 90 days
Lower Administrative Costs
Deprecate Existing Antiquated Technology
Increase Interdepartmental Collaboration
Increase Provider Directory Accuracy
Elevate Real-Time Analytic Reporting
Increase Provider Satisfaction
The world of healthcare is getting complex and disjointed. V12 Network is a seamless technology for managing complexity from operations to relationship management. Fostering deep collaboration between providers and payers. V12 Network is a comprehensive relationship & network management system that helps to organize and manage fragmented healthcare information and operations.
V12 Network is built on the Salesforce Health Cloud Platform.
Ready to learn more about V12 Network? The breadth and functionality of V12 Network spans far beyond one page of information, but this quick, in-depth overview will help you start digging in.
Reduction in Time for Provider Directory Updates
Reduction Time in Lead Set Up
Reduction Time In Account Set Up
Reduction Time in Multiple Location Entry
Day Saved Annually for Data Transfer
Who uses V12 Network:
Health Plans/Payers
Health Systems
Managed Care Organizations
Integrated Physician Networks
Accountable Care Organizations (MCOs, IPNs, ACOs)
Post-Acute Care Organizations (Senior Living Facility, Long-Term Care, Skilled Nursing Facility)
Third-Party Administrators (TPAs)
Whether you have a few quick questions, want a full demo of V12 Network or find yourself somewhere in between, we’re here to help.
Can’t wait? Call us at (615) 800-6768.
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