Self-Serve Rostering for Streamlined Provider Data Management in Healthcare
Managing provider data, especially with delegated credentialing, can be a challenge. Inconsistent rosters from different entities can create data inaccuracies, incompleteness and inconsistencies which in turn, when submitted with some data cleaning and manual consolidation, pose challenges for health plans and digital health companies.
Certify’s RosterOS offers a solution. It's a web-based platform that simplifies data management in two ways for:
- Health Plans with Delegated Credentialing: Delegated entities (hospitals and clinics) can directly upload and manage their provider data in a standardized format. This eliminates the multiple hops the data file takes, removes the need for manual consolidation at every stage, and instead saves time for health plans.
- Health Plan Systems and Digital Health Companies: Providers can update their information directly, ensuring data accuracy and consistency. There is a check on tracing the source of information obtained and a record of additions, changes, and terms on the provider data records. This allows for clean, exportable data to be populated for directories and websites, improving accessibility for health plan members or patients.
RosterOS: A Solution for Stress-free Provider Data Management
Traditional rostering processes can be cumbersome, especially with delegated entities. RosterOS tackles these challenges with:
- Reduced Administrative Burden: Both delegated entities and health plan teams benefit from simplified roster management. Automated validation and standardization minimize manual effort.
- Ensured Data Quality: Standardized data formats ensure clean data, eliminating the need for extensive data cleansing and validation within health plan systems.
- Real-Time Updates: Automated processes for receiving and validating rosters from delegated entities lead to real-time updates and increased efficiency.
The Bottom Line
Self-serve healthcare provider rostering with RosterOS streamlines provider data management, improves data accuracy, and reduces administrative complexities. This translates to a smoother experience for healthcare providers, health plan teams, and ultimately, better care for plan members or patients.
Want to know more? Book a free demo or contact the sales team at sales@certifyos.com.
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- BlogSimon Maas is originally from Vancouver, BC where he grew up in a family of physicians. He earned his BA from Harvard where he was also on the varsity lightweight rowing team. He’s been the COO at Certify since October 2023 and lives with his family in Los Angeles.
- BlogFor health plans, maintaining accurate provider information is essential for regulatory compliance and claims processing. Delegated credentialing serves as a valuable strategy to offload administrative tasks, but it also creates new challenges. While delegated entities manage their provider rosters by verifying and monitoring providers, a significant issue arises when these entities return rosters in incomplete, inconsistent, or incompatible formats. This creates a substantial burden for health plan teams who must manually clean, validate, and ingest this data into their specific data schema and format that drives downstream business processes.
- BlogCredentialing is an essential part of enrolling your providers in new health plans so you can tap into new patient markets. But it also involves many time-consuming verification steps and strict regulatory requirements—and you’re often stuck waiting on payers to handle them.