Provider Portal
Built for your Health Plan, MSO, or TPA
Efficiently communicate and disseminate information and documents to your physician network.
Allow providers to easily submit claims and view claims status
Enable providers to submit authorizations and view auth status
Increasingly, physician practices expect their health plan partners to offer a provider portal that allows
them to: 1) submit authorizations and referrals, 2) view claim status, 3) confirm payments, and 4) check
member eligibility. Health plans have traditionally relied on EHR add on modules that typically offer
limited functionality, poor interfaces, and lack of integration to other applications. This reflects poorly
on the health plan, resulting in lower physician satisfaction and creating an ongoing burden on internal
staff still working with providers that do not utilize the portal.
Enter Your Customized Provider Portal
We leverage our extensive domain expertise and our ability to create a custom solution efficiently
that results in the highest provider utilization and satisfaction. Example client results:
- Surgical referrals increased from 0% to 83% in less than 6 months*
- 100% f claim status and payment status via provider portal in 3 months**
- Email and fax-based provider interactions decreased by 85+% and replaced by inquiry forms, notices and chat.*
- Increase from 30% to 80% of physician network utilizing provider portal*
- 50% decrease in billing errors**
* TPA Results
** TPA and Health Plan Results
Provider Portal Core Features
- Review and Approve Claims
- Show Member Eligibility
- Referrals Authorization Management
- Review and Approve Provider Enrollment Applications
- Provider Manual
- Create Provider-Focused Email Templates
- Chat Feature Allow Documented Communication between Provider and Health Plan Staff
- Document Management
- Custom Dashboards
- Custom Reports
- Permissions Management
- Manage Physician and Vendor Rosters
INCREASE THE PRODUCTIVITY OF YOUR PROVIDER SUPPORT TEAM
ADDITIONAL FEATURES MAY INCLUDE:
- HEDIS recommendations
- Provide Evidence of Payment (EOP) summaries
- Single Sign On with other systems
- Gather Provider Feedback with Provider Survey Module
- Provider Quality Reporting Module
Free up your provider support staff’s time and increase efficiencies by utilizing a provider portal
designed for your type of organization (Health Plan, TPA, or IPA).
Custom Provider Portal Benefits
- Dramatically reduce your staff’s provider support time
- Allow provider self-service for claims, payments, authorizations and more thereby increasing provider satisfaction
- Reduce multiple channels to a single channel of communication
- Provide better auditing of requests, responses, and staff interactions
- Provide consistent and reliable communication, reporting, and feedback