Provider: Operational Constraint Meets Automation

By Kyle Mey

Automating Provider Operational Constraints

Many businesses run into operational constraints: you’re either growing too quickly for your recruiting team to fill chairs or you haven’t quite figured out how to scale your operational output to new volumes. Growing a company is a complicated process that requires a lot of balance, and growing a digital health company and disrupting a market as entrenched as health care, requires an unyielding resolve. For many digital health start-ups, getting more providers onto their platform is an essential part of their growth strategy. But how exactly does this process work?

Provider Screening

As digital health start-ups grow, adding providers to their platform becomes more of a necessity and controlling costs might rear its head as a secondary priority. The contracting process becomes the primary way of bringing providers onto your platform and controlling costs. But how do you know if the providers you're contracting and expansion team is bringing onboard are the right type of providers you want on your platform, outside of their specialty? Maybe you have already contracted with several providers who you realized were Federally sanctioned or excluded during the credentialing process. Imagine if there was a way to pre-qualify your provider leads before your contracting team devoted resources to closing their provider agreements or before your credentialing team even begins to assemble the primary sources?


After the contracts get signed, the credentialing process typically begins and ensures that the provider is qualified to offer the types of services of their specialty by sourcing their credentials from primary sources: license, board certification, etc. Today, that process is incredibly manual and requires teams of people sourcing the credentialing material, one source at a time — which leads to increased overhead spending, data validity errors, and expanded delivery times on your providers being added to your revenue cycle. 

To cut costs, many companies outsource their credentialing to credentialing verification organizations or CVOs, who in turn, outsource their primary source verification to offshore processing centers, because they haven’t been able to automate or innovate the primary source lookup. This leads to lower visibility into when the credentialing process will conclude and generally longer turnaround times on credentialing packets. Health care is an industry laden with measurement and not being able to see when the provider your contracting team just signed can enter your revenue cycle — is unacceptable.


When the providers make it through credentialing and enter the platform of the digital health company, the journey typically ends; or does it? How do you know if their license is in good standing after the credentialing process? What happens if they are added to a Federal exclusion or sanctions list and the firm has no idea? That is when active monitoring becomes essential. It keeps tabs on your providers for you, so you can focus on growing your business instead of building manual reports or hiring staff to run manual checks on your provider panel.

Verified Automation

Verifiable has addressed the pain points of manual primary source verification through automating the process, end-to-end, to ensure high-speed verified credentials to meet the demand of your growing business needs. Verifiable is with you at every step of your provider data journey: from pre-screening clinical candidates, to delegating your credentialing, or ensuring that your provider panel is actively monitored — you have a partner in your provider data journey.

If you have questions or are looking for help in any of these critical areas - be sure to get in touch and we’ll be glad to help!