Treating Compliance Challenges as an Opportunity

Our client is a managed care organization helping North Carolinians access behavioral health services. By connecting individuals with community programs, they focus on improving recovery and well-being locally. However, operating in the healthcare industry has complications—especially with strict state regulations.

North Carolina requires health insurers to contact state-provided physician networks to ensure enrollees have accessible care options. Compliance isn't optional for organizations like our client. Failing to meet these requirements can result in financial penalties, corrective action plans, and damaged reputations.

Prior to Penrod’s expertise, they relied on manual processes that were outdated and inefficient. And that’s where this partnership’s story begins.

Challenge

Complying with state reporting requirements for physician network outreach

Solution

Salesforce Managed Services

Results

Compliance with state regulations, faster reports, and transparency into outreach efforts

The Problem

Imagine relying on handwritten notes and manual data entry in a digital-first world. That was the reality for our client.

Every week, the state provided updated lists of physician networks. Those lists would then be manually assigned to agents for outreach efforts without any means to track progress effectively. Agents were responsible for documenting their contact attempts and outcomes individually, using manual notes to detail whether contact had been made, whether it was successful, and what was discussed. Sound tedious? It was.

The lack of a centralized tracking system had several consequences:

  • Lack of Reporting Transparency
    State regulations required our client to provide proof of outreach, something manual notes simply couldn’t deliver reliably. It was almost impossible to verify contact audits, and generating reports became a resource-heavy task.

  • Inefficiencies in Outreach
    The manual nature of the process burdened provider support teams. With no clear audit trail or streamlined workflow, agents struggled to prioritize tasks effectively.

  • Non-Compliance Risks
    Our client faced the threat of not meeting reporting standards, which carried heavy risks in the form of financial penalties, corrective action demands, and potential damage to its standing with providers and members.

The stakes were high—and the clock was ticking. Our client needed a robust, scalable solution to ensure compliance and optimize its operations.

The Solution

Enter Penrod and Salesforce. Penrod's partnership was about building a tailored solution that tackled compliance concerns head-on while improving outreach efficiency. And it delivered.

A Customized Implementation to Reimagine Outreach

The magic started with Penrod’s recommendation to use Salesforce as the solution's backbone. Why Salesforce? Two reasons stood out:

  • Detailed Activity Tracking
  • Comprehensive Reporting Capabilities

Our client’s physician network lists, provided by the state, were imported directly into Salesforce. No more manual data entry, no more paper trails. From there, tasks were assigned to agents, and Salesforce tracked every interaction, from the first call attempt to closing the loop. Task assignment ensured the platform reliably logged all activities, eliminating human error.

Structuring the Process with Workflows

A centralized system isn’t worth much without organization, which is where Salesforce’s workflow capabilities came in. Penrod designed a clear, structured workflow with defined stages for each provider:

  • Pending Contact
  • Contact Made
  • Contact Completed

This structure offered agents guidance at every step of their outreach. No more guessing or sifting through stacks of notes—just clarity and progress.

Reporting Made Seamless

The real game-changer? Salesforce’s robust reporting tools. The platform allowed our client to generate audit-ready reports with detailed logs of every contact. These reports included critical data they needed to comply, including:

  • Contact Attempts
  • Outcomes
  • Summaries of Discussions
  • Timelines

Presenting this data to regulators was no longer a headache. Instead, it became a breeze — automated, consistent, and always on time.

Results

The partnership with Penrod paid off. Implementing Salesforce transformed their outreach process and delivered tangible, measurable results:

Compliance Achieved

Our client is now fully compliant with North Carolina’s regulations. Requirements that once felt like monumental challenges are now handled efficiently through Salesforce’s tracking and reporting features.

More Efficient Agents

Efficiency lifted the manual burden on provider support teams. Agents now follow straightforward workflows that quickly prioritize outreach tasks and complete their responsibilities. Productivity? Skyrocketed.

Simplified Reporting

Generating reports used to be a labor-intensive process. With Salesforce, it’s now automated and accurate, meeting state deadlines effortlessly while reducing the risk of errors.

Centralized Operations

One accessible platform now houses all information about physician networks, outreach outcomes, and communication details. This centralization ensures transparency and fosters better collaboration among teams.

Agent Spotlight

Our client’s agents have also expressed how much the system helps in their day-to-day tasks. By removing the “guesswork” and offering transparent workflows, they can focus on building better relationships with providers instead of worrying about whether they missed an assignment.

Conclusion

Our partnership demonstrates what’s possible when compliance drives improvement. By implementing Salesforce, Penrod helped resolve our client’s compliance challenges and delivered lasting efficiencies that benefit their teams and the communities they serve.

There’s no stopping here. Our client is exploring future opportunities to leverage Salesforce across their organization further. Stay tuned—this is just the beginning of their transformation.

Compliance with State Regulations

Faster Reporting

Transparency into Agent Activity

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