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Pathway to Efficiency: Key Insights Into Transforming Credentialing

In our recent webinar hosted by Becker’s Payer, Jim Dwyer, Chief Transformation Officer and President, Jordan Armstrong, Client and Growth Officer, and Divya Pillai, Payer Delivery Leader, explored the present healthcare credentialing landscape and the impending credentialing crisis – and how you can successfully navigate them using technology-driven workflows.

DECEMBER 06, 2023

Payers today are fighting numerous battles in credentialing, from complex manual processes to large volumes of data, compliance requirements, and disconnected systems. Credentialing workflows are in immediate need of improvements to boost both the efficiency and the quality of data collected throughout the process.

In our recent webinar hosted by Becker’s Payer, Jim Dwyer, Chief Transformation Officer and President, Jordan Armstrong, Client and Growth Officer, and Divya Pillai, Payer Delivery Leader, explored the present healthcare credentialing landscape and the impending credentialing crisis – and how you can successfully navigate them using technology-driven workflows. 

Let’s explore these points and the steps you can take to get on the pathway to efficiency. 

The State of Credentialing Today

It’s fair to say that providers find the current credentialing process redundant, burdensome, and friction-fraught, turning into a barrier to their claims, billing, and collection processes. It’s expensive and labor-intensive. And it often lacks the verifiable longitudinal provider record that could help achieve data integrity across the system. 

There are many interconnected parties involved, from government agencies to verification sources and health systems. You must meticulously validate board certifications, conduct thorough background checks, verify educational and work history, and rigorously assess references. This adds up to a lot of manual work. For each practitioner, to get an application across their network requires over 24 hours of administrative investment on the provider side. And every day that a provider cannot see a member, there’s an estimated loss of revenue of $7500 a day for payers. Additionally, payers allocate substantial financial resources to credentialing, leveraging technology, databases, and operational infrastructure within diverse systems that underpin enrollment and credentialing processes.

Another notable issue is the lack of interconnectivity among the numerous systems and teams. These disconnected systems, without a central source of records, lead to taxing, tedious, and costly management of independent databases. These challenges, along with data integrity gaps, affect both costs and data quality, subsequently impacting patient safety.

When the credentialing process is inundated by so many complexities and roadblocks, how can you achieve true efficiency? 

Attacking the Credentialing Crisis

As an industry, we must commit to delivering higher quality and more efficient workflows to provide timely access to care. We need to leverage seamless technology, efficient processes, and data as a commodity to feed into a single unified database that creates that longitudinal representation of the provider. 

We define this into three steps that both payers and providers should act on:

  • Engage disconnected systems and processes to increase interoperability.

  • Eliminate manual and obsolete processes to prevent costly holdups.

  • Expedite the modernization of your technology landscape to improve workflow efficiency.

When should you do this? Well, now. There is no time to waste in saying goodbye to labor-intensive and costly credentialing processes. 

Still not sure where to start? That’s where we step in.

Sutherland Credentialing CVO

At Sutherland, we have over 20 years of experience with provider data management and credentialing with national and regional clients. Sutherland CVO enables this with our domain and design experts who work with your organization to create the best-in-class experience for you, providers, and health systems alike. 

And we do this with our proprietary platform, Sutherland SmartCredTM. Built on experience-led design, our goal is to craft an enduring, integrated, and connected experience. No matter where you currently stand in your existing landscape and processes, we are ready to provide assistance. 

Combining deep domain experience and nimble technology, we can revamp your credentialing workflows, creating seamless integration and customizing solutions that are unique to you. And whilst doing that, we also foster cost effectiveness, lowering 30-50% of our clients’ operations cost.

Join the Pathway to Efficiency 

Don’t continue to battle against frustrating and tedious processes. With a credentialing crisis looming, you need to make the change now to efficient credentialing processes. By investing in automation and AI-driven tools, you can improve efficiency and reduce costly holdups. 

And you don’t have to do it alone. Sutherland SmartCredTM is truly one platform, one solution.

Want to learn more about transforming credentialing? Check out our on-demand webinar here.

Sutherland Editorial

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