Healthcare in the US faces numerous challenges as it shifts to care models that are more value-based, more digital, and more equitable. Adapting to meet these challenges requires innovation within payer and provider organizations that embrace automation, meaningful data, and interoperability.
In this solution guide, we define how a proactive approach to provider network eligibility can help payers create greater efficiency and profitability within their government programs, reduce the risk of ineligible claims, and improve interoperability and collaboration across functional teams.
In this guide, you’ll learn:
- How to reduce the risk of ineligible claims
- Strategies for improving collaboration across functional teams
- Strategies for preparing provider data for interoperability
- Three steps to achieving continuous provider eligibility