Revolutionizing Healthcare Credentialing with Salesforce

The Problem

Our client knew that transforming the credentialing process was crucial to improving operational efficiency and enhancing patient care.

To tackle this issue head-on, our client contacted Penrod, a Salesforce partner known for its innovative, technology-driven solutions. The goal was clear: from onboarding to provider lifecycle management, the new platform needed to be holistic, automated, and immune to errors that could jeopardize patient service and regulatory compliance.

In this comprehensive case study, we’ll chart the steps taken by our client to completely reimagine their provider credentialing platform. We’ll dissect the challenges they faced, the strategic deployment of Salesforce Health Cloud, and the transformational impact it had on their daily operations.

A Legacy of Lag

Manual work, delays, and inaccuracy marred our client’s credentialing process. The onboarding process was not only labor-intensive but lacked a unified structure. This disorganization led to extended timelines as staff searched disparate sources for information like prior experience, accreditations, and professional history.

In healthcare, timing is a critical factor for patient outcomes. Any delay in onboarding a new provider means a delay in scheduling patient appointments. Furthermore, errors in onboarding processes could lead to legal complications and even damage the clinic’s reputation.

Mapping the Revolution

The first phase of this project involved a comprehensive mapping of our client’s existing processes. This meticulous exercise unearthed impediments to efficiency – and identified critical touchpoints needing enhancement.

After the thorough discovery period, Penrod suggested a tailored Salesforce Health Cloud platform – customized for the credentialing use case – to bring efficiency, unity, and reliability to our client’s credentialing process.

The new platform integrated every aspect of the data lifecycle, from payor enrollments to offboarding and everything in between.

By connecting Salesforce Health Cloud to CAQH, the new platform empowered rapid, automated record verification.

Building the Custom Framework

At the heart of the new platform lay a custom-built provider data object model tailored to fit our client’s unique requirements. This model, constructed on the bedrock of Salesforce’s flexible architecture, was configured to harmonize with existing business goals.

This framework ensured a frictionless experience for clinicians when submitting their credentials. Web forms empowered new quality-of-life features, including the ability to save progress and resume later, a huge convenience for busy healthcare professionals.

Our client’s new credentialing solution provided a guided path for clinicians as they navigated the application process. Automated notifications and task assignments, issued by a centralized engine powered by AI, streamlined this once-burdensome affair into a symphony of efficiency.

Gatekeeping with Precision

The system ensured that only accurate, verifiable data entered the provider’s profile by executing predefined rules and validation processes.

Our client’s credentialing apparatus thrived on the power of Salesforce's automation, leveraging our partner Verifiable to curate primary-source information. This integration offered our client’s team real-time verification from authoritative databases, such as CAQH, in a unified interface.

The Results Are In

The switch from timely manual processes to a nimble, automated credentialing system created a variety of benefits across the organization, from the finance department to the frontlines of patient care.

What was once a protracted, opaque process was now swift and predictable. Onboarding times were significantly reduced, allowing new providers to engage with patients faster.

The drop in revenue caused by onboarding delays was a thing of the past. Rapid onboarding ensured a sustained revenue flow, empowering our client to further invest in its mission and reach more patients.

By eliminating errors and omissions, the new system greatly reduces legal risk.

For the clinicians themselves, the transformation was palpable. The experience of submitting credentials and navigating the onboarding process was no longer a chore but a streamlined interaction that reflected our client’s commitment to operational excellence.

The Future of Credentialing, Today

The deployment of our client’s Health Cloud credentialing solution was not just a technological upgrade; it was a declaration of intent to never compromise on patient care. With improved access to a growing roster of providers, our client stands at the top of healthcare organizations committed to bettering patients' lives.

The insights garnered from this transformation will continue to improve our client’s operations and the broader healthcare community as they grapple with the evolving demands of a field entrenched in change and innovation.

Continuing the Journey

Our client’s success shows hope for healthcare providers facing similar credentialing challenges. The message is clear – a daunting, labor-intensive process does not have to be the norm. With the right partner and a solution built on Salesforce, the future of healthcare credentialing can be efficient enough to serve growing patient populations with the physicians they need.