Provider Network Operations

Enabled by our proprietary Provider Forward™ platform, Sagility’s Provider Network Operations (PNO) solution is comprised of critical components that are vital to building and maintaining a thriving healthcare network. Our PNO services streamline healthcare delivery and amplify provider satisfaction. By fortifying a reliable provider network, we enhance healthcare accessibility and quality. Our system offers transparent visibility into the provider’s journey, implements data quality enhancements, and delivers significant operational cost savings.

 

  • Decreased Cost of Credentialing by 50%
  • Increased Accuracy in Claims Adjudication by 35%
  • Reduced Cost of Provider Data Management by 50%
  • 40% Increased Efficiency Through Automation

 

Contact us now to explore our full suite of services, including Credentialing, Provider Data Management, and Provider Data Validation.

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Provider Data Management and Credentialing (BPaaS)

Sagility’s Provider Engagement solutions exist to help our clients meet the srtringent new rules around the quality of their provider data. Our core Provider Forward solution allows our provider outreach agents to most efficiently collect the necessary data and enables additional complex capabilities like Provider credentialing and recredentialing. Our data hub-based solution creates a profile of each provider and tracks all of the interactions with that provider, their admin, and associated health systems across their interactions with our agents, our self-service portal, and other service providers. These profiles are used to ensure each provider is contacted in the most effective way and reduces the amount of outreach necessary to keep your directories up to date. Complex tasks like credentialing are built on top of an automated primary source validation (PSV) process that reduces the effort in completing a credentialing cycle from days to hours.

 

Provider Credentialing

Sagility transforms provider credentialing with its robust application review, efficient outreach for missing information, thorough primary source verification, and seamless committee routing. Enhanced with Provider Forward™ enablement, Sagility supercharges credentialing through third-party verifications, automatic audit and committee review assignments, powerful insights, and automatic creation of queues and alerts for re-credentialing. Through our comprehensive approach, we ensure an effortless process and crystal-clear oversight for leadership, while mitigating regulatory penalties.

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Provider Data Management

Sagility’s innovative Provider Data Management solutions master the challenges of improving provider directory accuracy, from demographics to contracted services. It cuts down on manual, error-prone work with roster automation and smart workflow management, while our provider portal ensures seamless data handling. Utilizing data quality control and deduplication features, we tackle data redundancy. Moreover, our omnichannel communication eases the burden on outreach agents and improves collaboration with providers, thereby ensuring higher directory accuracy.

Provider Data Stewardship Earns Wins in Quality, Compliance, and Cost-containment

Sagility resolved data management and operational challenges for a rapidly growing health plan by implementing a comprehensive solution that optimized provider data management (PDM).

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Saving $1 Million with Improved Data Accuracy

Thanks to Sagility’s groundbreaking Provider Forward platform, a leading physician network provider was able to save nearly $1 million while improving data quality and reducing provider abrasion. 

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