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3 Ways Health Plans Can Optimize Networks with Verifiable


Amy Chait

Is network optimization top of mind for you? While often considered a compliance necessity, credentialing and networking monitoring, when done well, can drive significant time and cost savings as part of your overall network optimization strategy. 

Verifiable focuses on innovating credentialing processes because it is a vital first step in establishing relationships with providers and has major downstream impacts for managing high-performing networks. Transforming how we verify providers has unlocked up to 7-figure immediate cost savings and 98% reduction in credentialing turnaround times for leading health plans.

Our partnership with health plans has given us a clear view into the challenges they encounter in the effort to optimize their networks. Below are 3 proven ways that can play a strategic role for you in lowering costs, reducing provider friction, and guaranteeing access for members.

1. Centralize Provider Data to Create a Single Source of Truth

The first step towards optimizing networks begins with centralizing provider data. Connecting provider information and disparate verification sources within intelligent provider profiles for greater transparency and collaboration. With our pre-built application on Salesforce, the world’s #1 CRM, the intelligent provider profile becomes the single source of truth for your teams to manage provider insights, credentialing checklists, and ongoing verifications. Teams no longer need to switch tabs or systems to perform their jobs with ease.

2. Automate Credentialing to Quickly Expand Trusted Networks

Verifiable ensures accuracy, efficiency, and simplified experiences for providers by automating the entire credentialing process based on NCQA standards. Providers are easily guided through applications with auto-fill data entry that connects to CAQH profiles and includes error guardrails to avoid unnecessary follow up. Once applications are completed, credentialing teams can perform one-click verifications returned in seconds. Verifiable connects to 3200+ trusted sources and auto generates packets for medical committee approval. Now you can welcome providers into your network in a matter of days instead of months.

3. Proactively Monitor Networks to Ensure Compliance 

Whether you delegate, outsource, or manage credentialing in house, you should have a trusted solution in place to track and perform provider checks on an ongoing basis. Verifiable enables proactive network monitoring with auto setup at your preferred cadence to make ongoing compliance seamless. Our analytics dashboard provides insights into provider statuses to review license expiration dates and adverse events at your convenience. Be audit ready, while simultaneously safeguarding payment integrity and quality care.

If you’re ready to rethink your provider verification processes, let’s connect on how we can partner to drive immediate ROI on network operational costs and stakeholder satisfaction like we have for our other health plan customers.

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