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Maintain Precise Provider Data and Streamline Workflows
Provider Management solution helps in the management of network providers grading and standardized schedule of charges. It maintains comprehensive information about the providers and provides end-to-end empanelment of various service providers
Overview
ClaimsLive Health, our state-of-the-art and customizable technology platform for end-to-end digital claims management and fraud detection for health insurance offers an exclusive ‘Healthcare Provider Data Management Module’ that can manage the complexities associated with empaneling providers on your network such as hospitals, diagnostic centers, pharmacies, clinics, etc. and optimize their configuration to enable claim automation.
Functionalities
Leverage user friendly functionalities of the Healthcare Provider Data Management Module and achieve operational excellence
Pre-empanelment verification – Capture infrastructure, specialty, facilities, medical and para-medical staff details under each provider
Grade providers based on empanelment details captured and verified
Configure provider Schedule-of-Charges (SOC)/tariff
Configure provider billing policies
Add/remove providers to watch list
Handle request for voluntary termination from providers
Workflow for empanelment/de-empanelment, watch listing, suspension, de-empanelment and blacklisting of providers
Capture details for non-networked providers
Convert non-networked providers to networked hospital via empanelment process
Value Proposition
Healthcare Provider Data Management Module comes with a host of benefits to help you enhance your provider engagement
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Create Common Repository
Provide a one stop shop of provider information for increased operational transparency and improve data integrity
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Provide Data Accuracy
Streamlined workflows for provider empanelment reduces human error and eliminates data discrepancy with reliable data
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Enhance Provider Engagement
Improved provider data quality, leads to more accurate claim adjudication and reimbursement leading to overall provider satisfaction
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Issue1 Real Time Quotes/Policies
Instantly generate quotes and issue policies. Reduce load on your core insurance system
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Provide Quick Turn Around Time (TAT)
Delight your customers by providing quicker turnaround times for policy issuance, renewals, endorsements
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Ensure Greater Flexibility
Allows insurance companies to configure different privileges for pricing, underwriting and operations to
different intermediaries -
Gain Better Oversight
Take complete control over your distribution network with configurable levels of pricing and underwriting
privileges -
Increase Transparency
Manage complex commission structures and make payments online
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Be Eco-friendly
Help the environment by enabling end-to-end paperless process for policy issuance
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