Project Background
Our client is a large physician group that was experiencing major delays in credentialing and enrolling their providers with hospitals and payers. As one of the largest private Otolaryngology group practices in Southeastern Florida with 38 office locations that each has hundreds of practitioners on staff, the delays were a significant monthly cost in lost revenue. They turned to Acorn for a solution to improve efficiency and enable faster enrollment.
Typical Credentialing and Enrollment Process
The provider, the enrollment/credentialing department, and the leadership of an organization are all involved in this process. It starts with the provider applying to various hospitals for hospital affiliation and clinical privileges, and to payers for payer enrollment and contracting. The Medical Staff/Payer Enrollment Team then goes through the laborious process of primary source verification of the provider’s education, affiliations, licenses, boards, references, and other sources to compile a record of the provider’s training and experience. The industry’s average processing time for this step is 120 days, with 90 days as a gold standard.
Following the compilation of this data, the enrollment team fills out applications for each provider coming on board, as well as re-enrollment applications for the providers on staff. Misinterpretation of data, errors, and omissions could potentially result in negligent credentialing, which leads to significant financial and legal risk to an organization.
Client Problem
Our client was using a software that did not suit their workflow, business needs, or staffing demands. While it improved the efficiency of some processes, many tasks were still completed on paper or spreadsheets. Additionally, the repetitive data entry required to complete different payer applications was exhausting. While every payer that a provider enrolls with requires similar information, each payer organization has its own application format. Each provider was typically enrolled with at least 10-15 payers, which meant that the lengthy manual process was causing dissatisfaction among the providers.
The entire journey involved the submission and tracking of applications, repetitive data entry, and expirable tracking. It made the process tedious and labor-intensive, costing the organization valuable time, delays in patient care, and severe losses in revenue.
Acorn’s Solution
Our client adopted the Acorn Solution for Providers and Practice Groups and rapidly improved the productivity of the Enrollment Office. The platform’s easy-to-use interface and automation significantly decreased the turnaround time of enrollment applications, which enabled providers to begin billing in less time.
Acorn’s application management section increased the satisfaction of the Enrollment Staff, which led to a high adoption rate of the new solution. The expirable/renewal alerts and reports remove busywork, making things simpler and saving time. The interactive dashboard helps the staff plan the workload 90 days in advance, making them proactive and more effective.
In comparison to the client’s old system and its paper processes, Acorn increased efficiency by almost 80% in the first few months.
In comparison to the client’s old system and its paper processes, Acorn increased efficiency by 83% in the first few months.
Benefit: Provider Satisfaction
The platform offers each provider an accessible portal—the Medical Passport—which is a central repository for data and documents and gives control of the information to the provider. The ability to populate their data from a CAQH import and use a mobile scanner to upload documents streamlines the data entry process, creating significant time savings. In addition, once their data is entered in the Medical Passport, it’s easy to maintain and access at any time, plus the providers receive automatic email alerts about expiring credentials.
Benefit: Enrollment Staff Efficiency
Intelligently auto-populated applications with e-signatures mean that users complete and submit applications online, with an intuitive tool to track submissions and add follow-up dates with notes. This makes application submissions easier and faster than the old paper process. An added benefit includes the ability to have their group managers manage the process for them.
Benefit: Management Oversight
Our client appreciates Acorn’s real-time graphic dashboard, which keeps C-Suite managers informed of the progress of provider applications, expirable/renewal alerts, and other critical information. Additionally, the communication process with executive leadership is further streamlined by the ability to schedule and auto-email reports.
Summary
Acorn’s automated system helped our client integrate fragmented business processes, streamline the credentialing and enrollment process, and increase satisfaction of the credentialing/enrollment staff, providers, and executives. By speeding up enrollment processes and thereby accelerating the realization of revenue, our client realized savings in both time and money. The organization has increased enrollment with payers between 20% to 30%, resulting in an increased revenue of approximately 2% to 4% across the organization.
