Costly data acquisition fees, human data entry errors, manual processes, incomplete files and provider abrasion spurred Health Net to improve their credentialing and primary source verification process.
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Case Study
Health Net™: Improving the Primary Source Verification Process
The Challenge
As a result of its acquisition by Centene, Health Net needed to credential a 27% larger network with new types of providers. Health Net also had to meet Centene’s accelerated timelines for onboarding providers. Given the volume and the size of its staff, credentialing more providers in a shorter timeframe would not be achievable without additional resources.
The credentialing department was looking for a new way to manage the increased file volume and shorter deadlines. Health Net started exploring working with a CVO, but had concerns about the timeliness, data integrity, lack of responsiveness and unknown costs of working with a new partner.
Ultimately, Health Net chose CAQH as their Primary Source Verification CVO since their experience working with CAQH for Credentialing had been a positive one. CAQH provided highly trained staff and technology automation to help Health Net manage the larger file volumes while increasing the speed and quality of the process.
The Results
After implementing CAQH PSV, the credentialing team increased its file volume by one-third and improved overall quality by five percent.
Without CAQH, Health Net estimated it would have needed to hire six to eight additional staff to achieve similar results.
20%
Reduction
in labor costs
12 Day
Decrease
in the number of days required to complete PSV activities
5%
Improvement
in overall data quality
A More Efficient and Accurate Credentialing Process
Driving change with technology
CAQH solutions automate workflows, deliver a wealth of accurate and actionable data, and create a better experience for both providers and health plans.
Find out how more accurate PSV can accelerate your credentialing cycle.
Find out how more accurate PSV can accelerate your credentialing cycle.