Overview

QGenda Payer Enrollment automates application completion, submission, and tracking, as well as roster management, to simplify the enrollment process for both delegated and non-delegated credentialing. The solution is part of the same unified ProviderCloud platform as QGenda Credentialing, ensuring your provider data is connected to advance your overall healthcare workforce management strategy.

Features

• Maximize reimbursement potential: Complete enrollment applications with speed and accuracy — the first time — to reduce risk of delayed or denied claims.
• Improve provider data visibility: Gain real-time access to centralized data to track enrollment status across providers, departments, and locations.
• Increase staff productivity and bandwidth: Automate roster management and boost efficiency, so your existing staff can manage enrollment for more providers.
• Enhance provider and staff satisfaction: Deliver a seamless provider onboarding experience while reducing time-consuming, redundant administrative work.
• Automated Alerts: Automated alerts notify the enrollment team as soon as provider information is collected and verified, so there’s no downtime before starting the enrollment process. This helps ensure that providers can start billing for patient care as soon as possible with fewer claim delays and denials.
• Automation of Roster Reports: Automation of roster reports — in any payer format — supports delegated credentialing. Powerful features make it easy to configure reports to any payer, save templates, auto-update, and send reports directly from the system.
• Instant Access to Payer Applications: Jumpstart enrollment with instant access to an extensive library of commercial and government payer applications. Configure workflow templates to streamline task management and track progress. Configure payers by Tax IDs and/or locations to easily enroll and manage payer status for providers and corporate locations.
• Automatic Form-Filling: Automatic form-filling using information from the Provider Portal minimizes data entry for fast, accurate completion. A unique browser extension supports auto-population of online forms — even those behind a login or password.
• Embedded e-Signing Tool: A custom-built embedded e-signing tool increases flexibility and eliminates the need for third-party e-signature subscriptions or integrations — all while leaving a complete audit trail and ensuring security and compliance with eSignature laws, SSL encryption, and HIPAA.
• Ongoing Monitoring and Proactive Alerts: Ongoing monitoring and proactive, automated alerts for re-enrollment and contract re-credentialing make it simple for enrollment teams to keep track of expirations and renewals so that providers don’t fall out of network.
• Real-time Payer Lookup: Real-time Payer Lookup enables teams across the enterprise to view payer and contract status for all providers by payer, tax ID, and/or location. Configurable reports and dashboards make it easy to track, manage, and share enrollment status, action items, and progress.
• Robust analytics: Robust analytics provide visibility into key metrics – including staff productivity, overall workforce status, and average time-to-enroll by payer, location, provider, and more – to inform future staffing decisions and facilitate a healthy revenue cycle.

Benefits

• Reduce risk of delayed or denied claims.
• Gain real-time access to centralized data.
• Automate roster management and boost efficiency.
• Deliver a seamless provider onboarding experience.
• Reduce time-consuming, redundant administrative work.