TractManager: Dr. Erin Joins the SmartR Health System: A Day in the Life of Provider Onboarding
Lisa in the contracting office reviews the LOI, converts it to a contract, and sends it to Dr. Erin, a soon-to-be employed physician, in a timely manner. The contract lifecycle management system automatically pushes the contract to all required reviewers, and Lisa is alerted later in the day that Dr. Erin redlined and returned the contract for review. Lisa also sees that all reviewers have approved the changes. Confirming that the reviewers’ information has been recorded in the system, Lisa officially welcomes Dr. Erin to the SmartR system and community. Meanwhile, all of Dr. Erin’s information is shared electronically via an automated feed from CLM to CARE, SmartR’s cloud-based credentialing, privileging, and enrollment software.
Allyson, Medical Staff Specialist, receives the notification of a new provider joining the health system. Now that Dr. Erin’s signature is on file, Allyson sees Dr. Erin’s information in her work queue and is excited to get things rolling. Before CARE, Allyson’s job was manual, requiring a paper trigger such as an email or phone call; now, the process is automated and streamlined with workflow notifications. Processes including application intake through an online portal and primary source verification launch sequentially, and Dr. Erin’s packets advance to SmartR’s committee review and approval process.
In parallel, the system shares Dr. Erin’s information electronically with Anna, Allyson’s counterpart in enrollment and SmartR’s Enrollment Specialist. What once took Anna and Allyson weeks to accomplish now takes days. And with the reduction in time, there is also a significant drop in errors due to the centralization and standardization of the data in the system.
Through her expedited worklist, Anna is notified that SmartR’s Medical Affairs Office wants Dr. Erin to be fast-tracked, as the community is in need of her expertise. The system serves up SmartR’s contracted payer list so Anna can begin the enrollment process immediately. Anna knows to trust but verify all information in order to meet SmartR’s goal of reducing enrollment time and errors.
During Anna’s enrollment processing, she receives a call from Greg in the central Scheduling department. He has fielded an inquiry from a patient currently covered under Aetna who wants to see Dr. Erin. The centralized CARE provider management system shows that Dr. Erin is not yet participating with Aetna at that location, and Greg provides the patient with alternate care-givers. The patient, Joy, insists that she would rather wait for Dr. Erin to be participating. Based on experience and qualifying information from the CARE system, Anna explains to Greg that it should take 30 days for Dr. Erin to be enrolled with Aetna but asks that he make no promises. Greg informs Joy that he can go ahead and schedule her in 30 days, and the SmartR team will continue to check Dr. Erin’s status as the appointment date nears. Joy is grateful and tells Greg, “I wish every organization did this! My husband and I had a nightmare with a ‘Surprise Billing’ situation; we were shocked by what we owed, and it took months to fix.” Joy thanks Greg again and looks forward to her appointment with a trusted provider.
I wish every organization did this!” Joy thanks Greg again and looks forward to her appointment with a trusted provider
Later that afternoon, SmartR’s Chief Medical Officer and the CFO meet to review their onboarding process and determine whether they are meeting their five enterprise-wide goals:
1. Recruit qualified competent providers who meet the needs of their community.
2. Onboard providers seamlessly across their health system through CARE, their single source of truth.
3. Accelerate the timeline to get providers to see patients and generating revenue, especially during high-volume onboarding times of the year.
4. Maintain provider information compliantly and professionally, continually ensuring proper governance and quality of care across the health system.
5. Reduce redundant paperwork.
Leveraging CARE’s business intelligence data, the executive team accesses reports and critical business information that validate the success of SmartR’s onboarding process.
The Chief Medical Officer’s team presents high-level data on provider and patient satisfaction. The CFO’s staff reviews a packet of reports showing accelerating revenues and declining denials and bill holds. It’s another happy day at SmartR!