Credentialing physicians in mental health requires extensive data collection, verification, and input across numerous departments, from HR to regulatory compliance. As a result of our client’s manual credentialing processes, delays impeded their ability to get new physicians up and running quickly. Challenges ranged from the sheer volume of data needing to be processed to the persistence of outdated and inaccurate information.
Modernizing a manual provider credentialing process
A credentialing platform built on Salesforce Health Cloud
Faster credentialing, more accurate physician assessment, and quicker time-to-revenue
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.
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.
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.
Unifying the EcosystemThe new platform integrated every aspect of the data lifecycle, from payor enrollments to offboarding and everything in between.
IntegrationBy connecting Salesforce Health Cloud to CAQH, the new platform empowered rapid, automated record verification.
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.
A Guided Path to ProficiencyOur 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.
The system ensured that only accurate, verifiable data entered the provider’s profile by executing predefined rules and validation processes.
The Power of VerificationOur 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 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.
Swift OnboardingWhat was once a protracted, opaque process was now swift and predictable. Onboarding times were significantly reduced, allowing new providers to engage with patients faster.
Revenue ResurgencesThe 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.
ComplianceBy eliminating errors and omissions, the new system greatly reduces legal risk.
Clinician Experience ReimaginedFor 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 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.
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.
Swift and predictable processes reduce onboarding times
Physicians start generating revenue faster
Integration to CAQH ensures physicians are qualified
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