THE CHALLENGE
The credentialing, privileging and enrollment of healthcare providers is time consuming, complex, and never easy. For one medical staff affairs team at a southern U.S healthcare organization with 1,350+ providers, the process was manual and painstakingly slow.
Finding required information on a single provider meant digging through Excel spreadsheets and paper files. Preparing any report typically took a couple of days. And a task as simple as sending references and verifying a provider’s education, internships, and residencies took hours because names and addresses for providers had to be manually entered.
What’s more, data entry created an administrative burden for privileging, credentialing, enrolling, and beyond. Every time data was rekeyed the possibility of errors increased.
THE SOLUTION
The U.S. healthcare organization with three hospitals and more than 1,350 providers needed a centralized provider data platform to automate processes and keep pace with demands, enabling staff to quickly pull data to accurately credential, privilege, and license providers.
Through the symplr Provider cloud-based credentialing platform, which offers automated credentialing, privileging, payer enrollment, quality and risk management, the Medical Staff Affairs Director can have the correct answer to virtually any question in seconds.
“Before symplr, we would have needed an additional three, full-time employees to achieve what our existing team can do with symplr Provider. Ask the team almost any question about our providers, and with a couple of clicks we give you what you need to know. Spreadsheets and paper files have been replaced thanks to symplr software.”
-Medical Staff Affairs Director Southern U.S. Healthcare Organization
symplr Provider is highly automated, enabling staff to easily manage data and do their jobs as efficiently and accurately as possible. The technology collects, verifies, stores, and shares relevant information from the outside organizations’ databases, then delivers that data through every symplr Provider module that requires it, streamlining efforts of the medical staff services department.
THE RESULTS
“The time savings are truly unimaginable; I couldn’t begin to accurately quantify it,” says the Medical Staff Affairs Director. “Thanks to our centralized data repository and the hyper-flexibility of symplr Provider, everything we need is at our fingertips, and we’re not waiting on one another for information to take the next step.”
Since 2017, the healthcare organization has also used symplr Payer Enrollment to optimize the accuracy and timeliness of data that payers require. The automation pulls the information it needs, such as birthdates, social security numbers, National Provider Identifiers (NPIs), taxonomy, and more from the health systems’ centralized data repository so it is prepopulated.
“Ultimately, the Payer Enrollment module drastically decreases the chance that incorrect data will be replicated because we aren’t cutting and pasting,” says the Medical Staff Affairs Director. “If our providers aren’t correctly enrolled with payers, payments are inaccurate and delayed, and sometimes they don’t get paid at all.”
symplr Payer Enrollment is highly efficient because at least 90 to 95% of the information it requires already exists. As important, a significant percentage of the data comes from the credentialing and privileging side of the house, so it’s already been primary source verified.
If providers work with Medicaid and/or Medicare, symplr Provider auto-populates the appropriate applications, all of which had previously been handled manually. Additionally, the profiles, which are built as providers come onboard, can simply be attached to enrollment applications.
“We access and process the data more quickly to expedite the turnaround to the payer. I can run a query on 1,000 providers and export it in 60 seconds. Because of that, my head no longer swims when I get that type of query.”
-Medical Staff Affairs Director Southern U.S. Healthcare Organization
As much as the healthcare organization values’ the symplr Provider solution, the IT department appreciates the professionals at symplr even more. “When team members call symplr Support, they talk to a real person,” says the Medical Staff Affairs Director. “If it’s after hours, all calls are returned as promised. And if the symplr team hasn’t heard from us, they’ll call to see how we’re doing. We’ve relied on a certain level of service from symplr and have seen they know what works best for their customers."
ABOUT SYMPLR
symplr is the leader in enterprise healthcare operations software and services. For more than 30 years and with deployments in 9 of 10 U.S. hospitals, symplr has been committed to improving healthcare operations through its cloud-based solutions, driving better operations for better outcomes. Our provider data management, workforce management, and healthcare governance, risk management, and compliance solutions improve the efficiency and efficacy of healthcare operations, enabling caregivers to quickly handle administrative tasks so they have more time to do what they do best: provide high-quality patient care.
