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Points of Light 2022 Case Study 2
Payer/Provider Collaboration Reduces Credentialing Turnaround and Improves Denials Process
Author
Boyd Stewart
Author
Lois Krotz
Spectrum Health partnered with Priority Health to tackle two areas of inefficiency that were causing employee frustration and reducing productivity: the credentialing turnaround time and the denials process. A workgroup that included representatives from both stakeholder organizations was formed to identify areas of friction in these processes and to implement solutions. The results include improved member/patient satisfaction, increased staff productivity, and reduced denials. The collaborators note that success came as they were willing to fully commit to the project and work amicably on a shared objective.
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Key Findings:
- Executive Summary
- The Collaborators
- Points of Friction—Challenges to Be Solved
- Action Plan—How the Collaborators Worked Together to Reduce Friction
- Points of Light—Outcomes Achieved through Collaboration
- Lessons Learned
Writer
Elizabeth Pew
Designer
Madison Moniz
Project Manager
Mary Bentley
This material is copyrighted. Any organization gaining unauthorized access to this report will be liable to compensate KLAS for the full retail price. Please see the KLAS DATA USE POLICY for information regarding use of this report. © 2024 KLAS Research, LLC. All Rights Reserved. NOTE: Performance scores may change significantly when including newly interviewed provider organizations, especially when added to a smaller sample size like in emerging markets with a small number of live clients. The findings presented are not meant to be conclusive data for an entire client base.