The COVID-19 pandemic has impacted us all, including organizations, but especially those in healthcare. Due to the sudden surge in demand for telehealth, Amwell, a large telehealth provider, faced the need to scale quickly by onboarding more than 7,500 providers. But Amwell also had to ensure the CMS eligibility of every new provider, across the country. To achieve this Amwell found efficiency and scalability in consolidating all of their exclusion screening needs within a single platform: ProviderTrust’s Passport.
In this post, we tell the story of how Amwell partnered with ProviderTrust to successfully navigate the increased demand brought about by COVID-19.
Amwell: Large Telehealth Provider with Extensive Exclusion Monitoring Needs
Amwell is a large telehealth solutions provider that:
- Partners with 55+ health plans, 2,000+ hospitals and health system, and 81k providers
- Provides virtual healthcare services to 80 million members across the U.S.
Prior to the COVID-19 pandemic, to maintain their NCQA accreditation, Amwell was monitoring 3,500 providers for federal healthcare program ineligibility, including sanctions and exclusions. In addition to monitoring healthcare exclusion sources such as the OIG LEIE, SAM.gov, and state Medicaid lists, Amwell was also responsible for making sure no providers were on the Medicare Opt Out list.
Scaling Compliance Monitoring Efforts Quickly
From October 2019 to October 2020, telehealth claim lines nationwide skyrocketed 3,060%. Amwell’s virtual visit trends echoed what was happening nationally. According to the fourth quarter and full year of 2020 Amwell earnings call:
- Throughout 2020, Amwell saw a massive jump in virtual visits, totaling 5.9 million visits in 2020, up 400% from their total visits in 2019.
- In the fourth quarter, virtual visits totaled 1.6 million, up 300% from the previous year.
With the rapid growth in telehealth across the U.S. in 2020, Amwell faced the need to scale rapidly, including their compliance monitoring efforts. When the pandemic first hit in April 2020, Amwell was utilizing ProviderTrust for OIG exclusion monitoring and another vendor for sanction screening and Medicare Opt Out list monitoring.
Apart from facing increased demand for telehealth services, Amwell faced another challenge. They were using multiple vendor databases, which resulted in overlapping duplication of some sanction screenings, as well as a complex follow-up process. As they compared results between ProviderTrust and the other vendor, they found the other vendor had several sanctions and exclusion that went unreported due to outdated datasets. Amwell also found that the Medicare Opt Out list data was largely outdated, which led to delayed findings.
Automated, Continuous Exclusion Monitoring Allowed Amwell to Scale with Ease
Amwell was able to successfully onboard 7,500 providers from April 2020 to June 2020 and have peace of mind that exclusions and sanctions weren’t and aren’t missed. ProviderTrust worked with Amwell to ensure a successful implementation process for the additional monitoring services, including providing training and ensuring rapid team adoption. Passport allowed Amwell to scale quickly and seamlessly, providing real-time insights and transparency to the Amwell team.
- 7,500 providers were onboarded by Amwell during the 3-month period from April 2020 to June 2020
- 300-400 providers can be batch uploaded in about 10 minutes, which would have taken 3 FTEs the whole day to complete individual enrollments under the previously manual process
- 3-10 client audit requests are supported at any one time
ProviderTrust’s platform has also helped Amwell grow their market footprint by allowing health plan prospects to preview Amwell’s monitoring results during the pre-delegation review.
