Create a credentialing process that works as hard as you do.
Ease the administrative burden of provider credentialing without short-changing your network’s integrity.
Our robust process balances provider satisfaction and cost impact to elevate the quality of your network. Our tailored credentialing solutions can give your health plan an edge in improving network fidelity and preserve affordable, quality healthcare for your members.
Our stringent approach begins with provider identity authentication and review that inform a risk-score for each provider. Using risk mitigation strategies and our extensive knowledge of fraud, waste and abuse trends perpetrated by specific providers, we monitor data monthly to identify outlier behavior before improper billing can occur.
This standardized process adds value by keeping fraudulent providers out of your network before they have a chance to enroll.