Removing Human Error in Health Payer Data

Indellient

Indellient

Image of medical supplies

Often, human error results in inaccurate data. Today, we look at two common situations where human error surfaces in payer data and how the right technology can remedy these problems.

Client Onboarding

When payers onboard a new client, the process involves a considerable amount of data input from the new customer at first. Then, internal processes on the payer-side kick in. You have quality assurance, CMS, and other regulatory compliance maintenance and reviews that involve a lot of repetitive tasks and workflows. All of these tasks end up far too reliant on emails, spreadsheets, and other manual and person-intensive processes.

Document workflow automation is essential for client onboarding. The right system for your business simplifies processes and minimizes the potential for human error by tracking processes and documents. The system automatically initiating and following up on critical document reviews and approvals while streamlining and simplifying collaboration and communication.

All of this can also be done in real-time. As data and documents are moved through a system and updated, the system assigns attributes, tags, and stores information in a way to allow you to generate reports for future planning and strategy.

Provider Directory Management

By nature, provider directories are living documents that require frequent changes and updates. This is not just driven by provider changes where, say, one moves his or her physical location or adds or drops a service line and lags and is slow to communicate with a payer. State and national regulatory systems have placed the burden of updating and managing these directories increasingly on the payer.

CMS and state regulators have requirements for the frequency with which payers must contact practices to update information. Some states even require payers to contact providers monthly. This adds even more need for an integrated automated workflow solution with checks and balances to help teams update, navigate, and confirm accurate data.

In the right system, teams or individuals can be assigned a certain batch or number of providers for which information must be verified. Even more, parts of each individual’s responsibility within a team could be automated by triggering contact or reminders when it’s time to initiate contact with a provider.

Streamlined processes for how information is updated can start at the gathering, or credentialing, phase when a provider is new to your directory. Once licensing, education, and demographic information are collected at the outset, the system can be set up to assign team members, tasks, schedule reminders, and track the status of updates thereafter. 

Wrapping it up

Using a workflow automation tool for both directory maintenance and client onboarding clarifies where each team member must focus their attention and eliminates the tedious repetitive tasks and manual processes in their day to free them up for higher-level thinking.

Less email and spreadsheet chasing ultimately decreases the potential for human error, too. Teams can set up a system with the right checklists and approvals so that everyone understands if data is complete, updated, or needs attention.

If you’re a health payer struggling with how to decrease human error in your data collection and maintenance systems, it may be time to implement a more transparent, streamlined system that gets teams on the same page and helps you reduce costs while effectively serving customers and providers.


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About The Author

Indellient is a customer-driven professional services company that specializes in tailor-made software and tech solutions. We enable your business to get back to business with Business Process Automation, Document Management Systems, Business, and Operational Insight. Your companies Digital Transformation doesn’t have to be difficult, concentrate on what you do best and Indellient handles the rest.