The solution

A streamlined process on provider update work that was fast, automated, accurate and cost effective.

Add agility to remove complexity

It didn't take long for the client to join forces with Virtusa and transform the provider operations platform with an efficient, scalable solution. Broadly, the client required three main issues to be addressed in the future state:

Experience streamlined data management from a single point of intake for provider data for all provider data updates (Rosters, Provider Portal, Public Web Portal, Email, Phone, Fax and In-Person)
Reduction of manual intervention with development of a Smart Rules & Decisioning Engine (Roster File Processing & Bulk Provider Maintenance)
Reporting and audit capabilities to provide transparency and visibility to the external and internal stakeholders

Leveraging Pega systems' leading enterprise platform capabilities, the client addressed the various challenges Payers face in Prospecting, Contracting, Credentialing, and Pricing Configuration for Providers. Our deep-expertise based solution streamlined operations across the provider lifecycle thereby ensuring increased Payers satisfaction, improved efficiency and reduced onboarding time.
Virtusa's automated solution for the client's Roster File Processing enabled a futuristic end-to-end automation of their Provide Life Cycle Management (PLM).

This effectively covered the multiple dynamics of provider data management and enabled efficient and intelligent workflow management to meet the business objectives.

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