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
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.
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
Healthcare Provider Data Management Module comes with a host of benefits to help you enhance your provider engagement
Provide a one stop shop of provider information for increased operational transparency and improve data integrity
Streamlined workflows for provider empanelment reduces human error and eliminates data discrepancy with reliable data
Improved provider data quality, leads to more accurate claim adjudication and reimbursement leading to overall provider satisfaction
Instantly generate quotes and issue policies. Reduce load on your core insurance system
Delight your customers by providing quicker turnaround times for policy issuance, renewals, endorsements
Allows insurance companies to configure different privileges for pricing, underwriting and operations to
different intermediaries
Take complete control over your distribution network with configurable levels of pricing and underwriting
privileges
Manage complex commission structures and make payments online
Help the environment by enabling end-to-end paperless process for policy issuance
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