Managing the credentials of providers is a time consuming and constantly changing set of data points that requires constant oversight. The combined labor and technology expense of managing credentialing in house and the lack of integration with other key elements of the revenue integrity processes, makes this unwarranted expense for medical groups.
CREDENTIALING
Comprehensive Credentialing Visibility
Dashboards provide the most current providers credentialing status
Dashboards provide up-to-date details on expiring credentials, immunizations, licenses, insurance policies and specialty certifications. See the plan status of all providers including those that are in the process of being credentialed. View the status of provider appointments for all facilities including privilege status, provider type and type of facility. Managing the timing of expiring credentials ensures that providers CAQH credentials are current, the insurance policies are in force, case specific credentials are managed and that all credentials are current with changing state and federal regulations.
Constant Monitoring and Business Intelligence Alerts
Managing the credentials of providers is a time consuming and continually changing set of data points that requires constant oversight. The resources both from a labor and technology point of view are an unwarranted expense for most practice groups and it is essential that provider credentials are properly managed.
At the end of the day practices need to know that providers are appropriately credentialed to provide the services reflected in the claims the practice submits. If there is an interruption to revenue from out-of-network denials related to a provider’ credentials, schedulers, billers and leadership needs to know about it immediately without digging through reports.
Constant Monitoring of Credentials and the Credentialing Process
We have mind mapped of the processes, dependencies and data that needs to be managed for all providers in a practice. The complexities of the credentialing process requires trained professionals, software that can track all the required credential information and business intelligence that is constantly surveilling credential expiration dates and hospital appointments to prevent interruptions to revenue. Synergy Revenue Integrity constantly monitors credentials and alerts your practice to events that impact revenue integrity.
BUSINESS INTELLIGENCE & PROCESS IMPROVEMENT SERVICES
See the Whole Picture, Make Lasting Improvements
The volume of data associated with every claim transaction is simply too great to manage without sophisticated business intelligence. Synergy Revenue Integrity puts analytics in your hands that help identify trends and patterns across all payers. Sophisticated analytics and drill through tools provide unique views and help identify the root causes of revenue integrity problems.
Synergy illustrates the impact of corrective actions and the progress towards quantifiable goals you’ve established. Daily updates show how each process improvement initiative is performing against your goals and ensures that everyone is on the same page.
