Provider Network Management Software

Healthcare provider network management includes expanding a payer’s network of providers and improving the efficiency of its operations within the network. Software for healthcare network management aggregates all the operational data from the provider organizations of a network and generates insights that the payers can leverage. This software application is a central repository of information about health plans, treatments, reimbursements, and medications. Based on insights garnered from this data, it is easier for payers to optimize the network and serve patients and providers better.   

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Explore Provider Network Management

There is increased pressure on health plans to improve the efficiency of provider network management and seamless provider contracting to lower the care costs and make healthcare more accessible. Custom-made provider network management helps in measuring and improving the provider’s performance and redefining networking procedures to focus the value of their healthcare service.

OSP’ custom provider network management software strives to eliminate redundant and manual provider data management, medical credentialing services, provider contracting and profiling systems through highly advanced provider network management automation. We tailor provider network management software solutions to enable an in-depth analysis to monitor provider performance against set benchmarks with real-time alerts to notify the major changes in provider performance. Our automated provider network management solutions are customized to perform an in-depth analysis of existing networks and assisting in the creation. To enable new and multi-tiered pricing structures with aligning contracts, fee schedules and data, team OSP can engineer advanced provider management solutions on payer demands.

With multiple users connected to the provider network system, workflow management becomes highly essential to reap the benefits of qualitative provider network management. Advanced network software solutions are built on leading enterprise platforms that enable organizations to manage multi-departmental process workflows and complex provider data structures in diverse settings.

We customize medical network management as per the payer settings with built-in Smart Business Rules, provider document checklists, Intelligent case routing, pre-defined state-based Rules, and many other capabilities. Intelligent workflow management significantly improves operational efficiencies for provider and network management organizations. With lean and six-sigma-based provider data management software helps to eliminate repetitive processes resulting in reduced FTE requirements and significant savings on operations costs.

Automated provider data management is one of the most essential components in provider network management. An integrated provider data platform helps to streamline the key functions of a provider profile lifecycle by configuring seamless process workflows, SLA tracking, and intuitive dashboards. Our healthcare provider network management strives to enhance the accuracy of the provider’s data and eliminate data redundancy through cloud-based data management solutions.

Health plans struggle to keep their provider data updated and accurate to offer their members an optimal care experience. Our healthcare provider network management system is customized to provide you multiple benefits by building a single source of provider’s data. We ensure expedited provider onboarding, proper credentialing, network management innovation, optimized cost of operations, simplified HIPAA compliance and many more.

Coordination plays a vital role in developing quality provider network development and management; especially in the credentialing and contracting process with the need to quickly evolve the provider networks. To provide the top-notch provider data management system, we focus on optimizing the process workflows of recruiting, credentialing, and contracting through the customized enterprise-based provider network platform.

Our team can program medical network management software solutions for diverse Healthcare-specific data models and workflows for diverse health plans to efficiently operate complex provider touchpoints and relationships. Our custom-made provider management software help aligns complex provider data hierarchies and relationships by helping providers to offer quick and quality services. Our tailored provider network management help reduce onboarding time through streamlined recruiting, Healthcare credentialing and contracting processes.

Complex regulatory compliance needs, modern care delivery models and complicated provider network needs an automated provider data management with advanced provider contracting solutions. Financial penalties, non-compliance, and lack of coordination in the provider network impact the quality of member care. To ensure care transparency and uninterrupted care delivery to the members, a good quality provider contract management is needed.
OSP’ can customize provider data management software includes provider contract management with a centralized contract management system with the fast-tracking process. We help you automate and control contract creation as per the business needs. With relevant templates for contract initiation, contract negotiation, reviewing & approval, achieving contracts can be easily handled.

We help payer companies with highly regulated and role-based access to Medical credentialing documents in an organized way. With our provider network management software solutions, you can retrieve provider data and documents from CAQH & other credentialing systems. OSP can customize provider credentialing as per your needs to simplify capturing and storing provider contract documents such as provider agreements, current insurance & license proofs.
Credentialing makes it easy to collect, store, monitor and organize credentialing data by year to month and the present in easy-to-access tabs. The solution can be tailored to automatically generate notifications when documents are outdated or missing to request the necessary information. The tasks of managing expiration dates, practice locations, and auditing materials to verify current documentation are solved through automated credentialing.

Benefits 

Managing a network of providers is no small feat, and it gets more complex as the network grows. But using a provider network management healthcare platform that OSP can build will help consolidate all the data surrounding providers’ treatments, prescriptions, tests, scans, claims, reimbursements, and patient health information into one interface. This makes the platform a powerful tool for business intelligence and aids in strategic decision-making, which leads to greater efficiency and productivity.

A large part of the operations surrounding provider management in healthcare involve manual, repetitive tasks for activities like provider contracting, provider credentialing, data analytics, onboarding, notifications, and so on. OSP can design solutions for healthcare network management to automate many of the activities mentioned above, resulting in a significant acceleration of workflows and a sharp reduction in errors. This will invariably go on to reduce overheads and also improve revenues in the long run.

One of the most important aspects of managing a provider network is ensuring that health plan members have a hassle-free clinical experience. OSP can develop provider network management software to help payers to optimize operations and gather insights from them. This enables them to make informed health plans, providers, and coverage decisions. Subsequently, using our provider management solutions indirectly results in better hospitals and clinics serving plan members.

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