Essentials Features

Automates the creation and setup of contracts and applications

Configures, customizes, or modifies credentialing paperwork and/or workflow

Maintains provider database

Provides varying access levels to administrators, stakeholders, etc.

Supports healthcare facility policies, requirements, and needs

Manages vendor or provider access controls and compliance

Adheres to or aligns with relevant industry regulation

Pulls data from a regularly updated or real-time provider database

Streamlines monitoring, screening, and verification of sources

Provides a built-in commitee review process manager

Stores and maintains credentialing documentation in the cloud

Stores and maintains credentialing documentation in a secure server

Automates notifying and following up with missing information or documentation

Ensures or facilitates the compliance of an overall health care organization to current regulation and standards

Easily integrates with health care IT solutions like EHRs, medical scheduling, and medical billing softwares

Automates manual administrative tasks to reduce error

Automates manual financial management tasks to reduce error

Streamlines any communication and data share between provider and clearinghouse

Streamlines the processing, scrubbing, and submission of healthcare insurance claims

Based on 10 Essentials reviews. Automatically populates data in claim submission fields

Supports electronically uploading and sending of healthcare insurance claims

Provides integration or facilitates relationships with clearinghouse(s)

Provides or facilitates a structured process to support the entire claims lifecycle

Promptly re-submits denied claims once providers update missing or lacking information

Ensures that patient data remains secure and confidential and that only pertinent information is shared

Digitizes, tracks, and vets submitted health insurance claims to check for errors

Enables in-platform (or provides access to services that offer) verification and validation of provider data

Supports and enables timely claims payment and reimbursement

Prompts providers to update out-of-date or inaccurate records

Improves communication between disparate health plans, systems, and plan administrators

Generates insights and reports from aggregated provider data to improve efficiencies and ready systems for audit

Manages and reconciles data from disparate sources

Automatically captures essential provider data, routes data to health plans, and tracks data to identify any data anomalies

Securely stores provider data and supports import and export to improve data governance, ensure data accuracy, and facilitate de-duplication