Payers who want to maintain a robust and compliant provider network must effectively manage all aspects of the provider lifecycle: identifying network gaps, recruiting providers, and then credentialing, enrolling, and onboarding them in a timely basis.

Payers who do this well realize many benefits: stronger provider networks, better access to care for members, and better cross-enterprise decision making. The challenge is that the internal systems supporting these programs are often siloed, which leads to data redundancies and increased operational costs.

Availity’s Provider Lifecycle Solution uses Availity’s nationwide network and innovative platform to help payers reduce the cost and complexity of managing the provider lifecycle while reducing provider frustration. The Provider Lifecycle Solution includes two interconnected modules: Provider Data Management and Credentialing Intake, which use digital technology to improve data access and use.

Credentialing Intake

Accelerate provider credentialing

Many providers find the payer credentialing process to be time-consuming and confusing, which erodes trust, increases call volumes, and potentially delays patient care.

With Credentialing Intake, payers can offer providers a streamlined, multi-payer digital intake process that captures all elements of a credentialing application. Prepopulated with provider data from PDM, providers are guided through an intuitive and comprehensive application process, ensuring that all necessary information is collected accurately and promptly. Once completed, the application is routed to the payers’ preferred credentialing verification team or vendor, who can then expedite the verification process.

By streamlining the provider credentialing process, payers help ensure their provider network is adequately served and that members have access to the broadest range of providers to address their healthcare needs.