Health care credentialing software automates and simplifies the process of vendor, facility, and insurance provider credentialing. To stay compliant with health care facility policies and requirements, credentialing software takes over the manual process of verifying, screening, and generating contracts, applications, and other forms. The software optimizes front and back health care office operations and workflows. Additionally, health care credentialing software can prepare health care organizations for audits, securely store reliable and/or up-to-date provider information, and ensure that all documents and accreditations are easy to find and remain secure.
To qualify for inclusion in the Health Care Credentialing category, a product must:
The Cactus Provider Management Platform is a web-based provider management solution that provides an easy and effective way to manage your provider information, from initial application, to provider credentialing & privileging, to provider enrollment, to peer review, practice benchmarking, analytics & incident reporting, all the way to recredentialing.
Cerner Corporation's HealtheRegistries solution allows EPs/ECs to attest to MU and ACI programs Clinical Data Registry option of the Public Health Objective. HealtheRegistries provides the technology to track and manage quality measures to improve population health outcomes. To meet the Public Health Objective, EPs/ECs are eligible to electronically submit data from a Certified Electronic Health Record Technology (CEHRT) to HealtheRegistries via HealtheIntent.
The Converge Platform is a comprehensive, enterprise software solution that integrates silo'd departments, facilities and systems with a secure digital workspace and workflow for high risk/high-liability data, providing the insights necessary to proactively manage governance, risk and compliance.
CubHub is a platform built specifically for pediatrics, rather than a Medicare-centered program with pediatric "work arounds." CubHub's outcomes-based data will enable you to partner more closely with private insurance companies, MCOs, referral sources, and key physicians—providing data to help you negotiate better contracts, get more referrals.
Helps you meet pressures with a full range of BPO and turnkey healthcare administration solutions, including advanced technologies and strategic consulting services designed to help you optimize member outcomes, focus on revenues, and manage risk to remain compliant
edgeMED provides expert revenue cycle management and intelligent technology to increase physicians' revenue and improve their operational efficiency - enabling them to stress less, make more and live more. Our Essential medical billing and collection service tracks, measures and collects more of the money you’re owed in less time than you thought possible, so you can see more patients and less paper work. Our expert U.S.-based team, located in Boca Raton, Los Angeles and New York, will not only handle your back-office workload, but we’ll help optimize your entire revenue cycle to ensure your organization is running at maximum efficiency and profitability – all without any management headaches all too commonly associated with medical billing. Plus, with our cloud-based practice management/electronic health records and telemedicine applications you can provide better patient care, while unlocking obstacles to higher reimbursement.
For medical auditing, Audit Manager streamlines the way you manage audits by merging audit workflow, management, education and reporting into one easy-to-use, web-based solution. Designed by auditors, for auditors, Audit Manager allows you to audit on your terms through immediate reporting, template customization, and total oversight of your entire audit program. With Audit Manager, you will improve your auditing efficiency by up to 40%, minimize denials and identify up to 10% in missed revenue.
The HIPS system is a comprehensive and integrated solution that covers every aspect of health insurance administration. From credentialing providers through claims reimbursement and electronic payment, HIPS is designed to maximize scalability and minimize administrative costs by working in a completely user friendly web-based environment.
Kyruus delivers provider search and scheduling solutions that help hospitals and health systems match patients with the providers best suited to care for them. The ProviderMatch suite of cloud-based applications--for access centers, consumers, & referral networks--enables a consistent patient experience across multiple points of patient access, while helping health systems align network capacity with patient demand. Kyruus’ provider data management platform, KyruusOne, forms the foundation of its solutions, powering them with accurate data. Our products include: * ProviderMatch for Access Centers - helps access center agents efficiently and effectively match and schedule patients with the right providers for their needs. * ProviderMatch for Consumers - enables consumers to search for providers, review comprehensive provider profiles, and book appointments on a health system’s website. * ProviderMatch for Network Referrals - allows providers to search for the right provides to refer to across their network and submit referrals to them efficiently online. * KyruusOne (provider data management) - automatically integrates data from multiple sources on an ongoing basis and provides user-friendly applications for effective provider profile configuration and maintenance.
Naviant offers world-class Health Payer Provider Enrollment Case Management Solutions to help health payers manage the Provider Credentialing process more effectively and with a higher degree of accuracy than the manual process most companies currently use today.
Newport Credentialing Solutions is the nation's premier provider of cloud-based software and services dedicated to the credentialing life cycle. Newport provides cloud-based workflow, analytics, and business intelligence credentialing software and cloud-enabled credentialing services to some of the largest academic medical centers, health systems, and multi-specialty group practices in the United States.
ComplianceLine™, a leading provider of compliance hotline services, now offers SanctionCheck an online searchable database for compliance officers, human resource managers, and anyone involved in the exclusion review process. SanctionCheck allows our clients to search for individuals or entities that have been sanctioned, disbarred or otherwise excluded from participation in federally funded health care programs 24 hours a day, seven days a week, from any location throughout the world.
The Vistar eVIPs provider data management system is a robust workflow solution that will automate and streamline all aspects of provider data management for health plans and managed care organizations, including credentialing, contracting, network management, quality improvement, ongoing monitoring & compliance, and more.