Ballad Health sought a more accurate, streamlined way to submit roster updates to the 30 health plans with which it maintains delegation relationships.
Ballad Health, a 21-hospital system with 800 physicians, maintains delegation arrangements with 30 health plans. Each plan required Ballad’s contracting and support services team to create and upload its roster in a different format on a different schedule. The team’s data analyst spent at least four hours every week submitting rosters and following up with each plan to make sure they were received.
A CAQH analyst helped Ballad’s team set up an automated process to pull data from their internal PDM system. Ballad’s data analyst uploads this data weekly into ProView for Groups, which runs quality checks on the data and allows Ballad to submit rosters to eight of its plans using a single standardized format that includes every data element the plans require. Each roster gets a date stamp when a plan accesses it, so Ballad’s team can rest assured that roster changes were received.
With the implementation of ProView for Groups, the health system is well on its way to streamlining the roster submission process. Staff are making better use of their limited time and rosters are uploaded correctly, faster. By submitting rosters to 6 of the 30 health plans with which it has delegation arrangements via ProView for Groups, Ballad Health has cut the time needed to process rosters in half while increasing data quality. The team spends less time preparing and sending rosters, correcting errors, and following up on roster submissions, freeing time for other projects. The team at Ballad Health expects to decrease the administrative costs associated with submitting rosters even further as they work toward their goal of getting the other 24 plans they work with to accept rosters via the same process.
The ProView for Groups process is easy and standardizes everything for everyone across the board. - Susan Whitfield, Database Analyst