success story

Transforming provider onboarding at a Fortune 500 healthcare company

A Healthcare company that focuses exclusively on providing government-sponsored managed care services, in North America, required to automate business processes to improve provider on-boarding timeframe, for market competitiveness.



The Challenge

Provide a system to accelerate provider network enhancement.

  • Provide a unified Provider 360 view.
  • Maintain data integrity between three core existing business systems (Prospecting, Contracting and Provider Relations) in ever changing business scenarios. Avoid swivel chair and provide a unified work space.
  • Need to automate business processes to improve provide on-boarding time frame for market.
The Solution

A unified, automated provider contracting platform that modernized all aspects of the client's complex provider relationships.

  • Integrated smart BPM to manage workflow, SLA, business rules, integrations with internal systems and provide regular updates to consuming systems.
  • Parallel processing of cases by creating sub cases and tasks.
  • Intelligent routing of cases based on agent availability, skill and work load.
  • The Network Management application was built as an end-to-end solution, which empowered business to configure state-specific rules.
  • This reduced dependency on technical resources, thereby debottlenecking the process and accelerating time to market.
The Solution
The Benefit

Automated Provider Contracting by leveraging industry-leading HCIF and other core PRPC workflows & business rules.

  • Slashed the client's Provider onboarding time frame from 90 days to 40 days, a 53% reduction.
  • 587 use cases built in just 020 weeks with 70% of functionalities being re-usable.
  • Onboarding time for standard contracts reduced to 15 days.
  • Complete elimination of documenting misses and errors.
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