How Verifiable helped Humana Dental accelerate its credentialing turnaround times by 98%
The Challenge
Humana Dental, a large dental insurance company with over 100,000 clinicians in its network, was looking to optimize its provider network operations to deliver a faster, more streamlined experience for its clinicians. However, it faced the same bottleneck that most health plans do when growing and managing their networks—credentialing. It had long turn-around times of almost two months for credentialing new providers because of a dependence on a siloed system, lack of process control, and slow timelines from an external credentialing vendor. Although Humana was already using Salesforce, it was unable to leverage it for full value because of a heavily customized, fragmented solution, and unreliable, slow methods for entering provider data into the database.
Health plan organizations often have siloed provider network processes services, which can lead to operational backlogs, major delays, added costs, and a poor provider experience. By automating and unifying network operations, eliminating bottlenecks, and optimizing the credentialing process, they can improve both operations, and the provider and patient experience.
How do they...
- Drop turn-around times for clinician credentialing?
- Unify provider data into a single operating system?
- Improve credentialing quality and control through insourcing?
- Scale their network while providing an excellent provider experience?
- Save money?
In the case of Humana Dental, the organization’s primary goals were to reduce turnaround times, and establish greater visibility and control within network operations. As a native Salesforce application offering real-time credential verification, Verifiable helped automate and unify network operations, eliminate bottlenecks, and insource and optimize Humana’s credentialing process. This netted Humana Dental significant savings, and a 98% reduction in credentialing packet completion times—less than one day, down from the previous 45-60 days.
The Successful Outcome
The combination of a revamped Salesforce architecture and Verifiable’s credentialing managed package mean that Humana Dental can now quickly capture accurate data from its providers and automate primary source verifications directly into Salesforce. Additionally, Verifiable has integrated the customized fields from Humana Dental’s legacy platform, Vlocity, into Salesforce, to save it operational time, and minimize the lift of a wholesale migration. This has allowed Humana Dental to bring the credentialing process in-house, credentialing providers in a fraction of the time it took their previous outsourced credentialing verification organization where it had limited visibility and control.
Considerations for insurance providers looking to streamline credentialing:
- Unify provider network operations and break down siloed operations for efficiencies in cost-savings and time.
- Ask yourself whether you are fully utilizing the capabilities of your solution. Explore the possibility of integrating all the elements of your solution to minimize errors and optimize time savings.
- Don’t migrate everything all at once. Consider a phased plan that meets your budget, timelines, and change management needs.