A multi-specialty facility overcame the internal credentialing software issues and successfully submitted 150+ applications
A large-sized multi-specialty medical practice in the U.S.
- Unable to add manage all the provider applications and/or each payer/provider status
- Problems in maintaining the appropriate step in the credentialing processes
- Credentialing process was time-consuming
- No credentialing software to help manage or provide the visibility required
- Denials due to “out of network” were rapidly rising
- Providers felt like the company was letting them down with credentialing services
Plutus Health's Plan:
Plutus Health's credentialing experts started the project with root cause analysis of the problems. We had a brief discussion with the client and detected the following problems.
Steps followed by Plutus Health/Solution provided:
- Plutus Health’s experts detected the reason for all the problems and started working on delivering solutions to overcome each one.
- Plutus Health immediately set up a team of developers and designers to provide support.
- With the help of the latest technologies, Plutus Health added new features and made the application more performant and easier to use.
- The client was satisfied with how quickly the Credentialing situation was turned around and now their providers are “in-network”.
- Credentialing related claims denials were dramatically reduced.
- Physicians are now able to see more patients with the Health Insurance companies that they are on par with.
- Patients are happier because they are now receiving their “in-network” insurance benefits.
- Successfully submitted 150+ credentialing applications.
- All providers are now “in-network” with their region’s main insurance companies
- Provider, employee, and Patient satisfaction has increased tremendously.
- Faster turnaround times with insurance reimbursements