With the average time for payer enrollment being upwards of 190 days, it’s crystal clear why so many organizations are taking on delegated credentialing agreements. When the provider group can handle the credentialing on behalf of the payer, the time it takes to get that provider in-network, seeing patients, and generating revenue is dramatically accelerated. Not to mention, when a provider group is set up to take on delegated credentialing agreements, it becomes a top selling point for attracting new payer relationships.
Most provider organizations willingly take on the additional administrative processes because it means a faster path to revenue. But it comes with a tricky drawback - generating regular provider rosters for every payer you are delegated with.
While usually a tedious, cumbersome process that requires spreadsheet mastery, we’ve leveraged our deep integration with Salesforce to make generating rosters easier and more repeatable.
But before we jump into our new capabilities, what is so difficult about rosters anyway?
Challenges with rosters today
Rosters contain all of the necessary provider data that the payer will need to keep their directory up to date, and typically includes the following:
- General identity and contact information
- Licensing
- Education
- Specialty and board certification
- Medicare and Medicaid numbers
- DEA and CDS
- Practice information
- Patient population info
- Accepting new patients status
- Credentialing date
- …more!
According to a CAQH survey, the average provider group contracts with 20 different health plans. If the provider group is managing the credentialing via a delegated agreement for all 20, that’s also 20 rosters that need to be maintained on at least a monthly basis. But with a lack of data standardization across payers, it means that each roster will need to be organized and formatted slightly differently to accommodate requirements.
Typical tasks for an enrollment specialist may involve:
- Export provider data to a .csv or .xls file
- Copy/paste into payer-supplied template
- Ordering and renaming data columns to match payer-supplied template
- Manipulate data to match payer’s field requirements (is birth date displayed as YYYY-MM-DD or MM-DD-YYYY)
- Share spreadsheet to payer via their desired submission method (email or document upload)
Rosters are typically generated monthly, or sometimes weekly, in order to share provider demographic updates (address, office hours, phone numbers, etc.), add new providers, or remove providers that have been terminated.
With 20+ different payer roster requirements, generating rosters regularly can quickly become a time-consuming task.
Simplifying Roster Generation with Verifiable on Salesforce
With Verifiable’s pre-built package for the world’s #1 CRM, Salesforce, your verified provider data and credentials are all housed in a centralized source of truth. Enabling you to accelerate enrollment turnaround times at scale with configurable rosters.
Here’s how:
Create roster templates based on payer-defined requirements
Templatized exports reduce room for error by decreasing the need for manual copy/paste and data manipulation. Simply drag and drop data fields in the order of the payer template, adjust column naming as needed, and save it for ongoing use.
Download payer-specific rosters in minutes
The simplified process for generating rosters can free up your enrollment specialists’ time so they can focus on more meaningful and fulfilling tasks. When rosters are exported, the data is formatted according to the payer template with the right column headers, ordering, and dataset.
Wherever you are on your delegated credentialing path, Verifiable is here to help. Check out our Delegated Credentialing Handbook if you’re just getting started.
If you’re already invested in a delegated credentialing program, we can help tighten your compliance, accelerate turnaround times, and automate 76% of manual tasks.
Schedule a demo of our complete enrollment solution today!
