providers

The Winter Olympics are here! If you’re like me, you’re looking forward to the excitement and thrills of international competition! I am a snowboarder so I have a personal love for winter sports and will be glued to my TV and social media feeds watching the events and keeping medal counts. There is such an inspirational culture built at the Olympics with athletes, as both teammates and competitors, pushing each other to be their best.
So why am I bringing up the Olympics? Two words: DETERMINATION & TRAINING. These exceptional athletes don’t just roll out of bed and suddenly they’re the best. They work hard – harder and smarter than anyone else. They train, plan, fail, learn, push, excel and do what it takes to be better than the competition in hopes that the long hours of preparing and executing a training plan will pay off. When the pressure mounts, these athletes will feel reassured that they’ve done enough to take their place on the podium.

Healthcare payers should have this same determined mentality when dealing with their Provider Networks. We all know that CMS is cracking down on the accuracy of Provider Networks and compliance and/or enforcement action is right around the corner. It’s time to evaluate your current processes, learn what’s worked and what hasn’t, develop an action plan and then train your team on how to support that strategy to ensure your Provider Data is up-to-date and accurate. Once you achieve that goal, it will take the same consistent effort and commitment to manage that data so it remains in compliance. Athletes have weights, cardio workouts, diet, a team of trainers and sponsor partnerships to keep them strong and competitive. Healthcare Payers have technology, experience, skilled employees and resourceful executives to keep them strong and competitive. Using solutions to monitor provider data and automatically execute provider outreach to verify data is how payers can train for their gold medal. You can’t sit idly or settle for what you’ve always done and expect to swiftly pass an audit when CMS calls. Times are changing and so should your business strategy. Make a choice to be the exceptional athlete in your industry and work hard, train, be a leader and surround yourself with a talented, knowledgeable team to help ensure success.

Kiriworks Like, Follow & Share:

You Can’t Manage What You Can’t See – Thoughts from the Optimizing Appeals & Grievances Conference

Much of the discussion last week at the Optimizing Appeals & Grievances and Improving ODAG & CDAG Outcomes Conference centered around accountability and company culture.  There was also a great deal of attention given towards the ability to pull Universes on demand.  These topics along with better ways to manage your day to day workloads are common challenges we hear from […]

Posted in Kiriworks Blog | Tagged , , , , , | Comments Off on You Can’t Manage What You Can’t See – Thoughts from the Optimizing Appeals & Grievances Conference

Building a Strong Network: It Takes an Empowered Team

Life is full of different experiences. Take a moment to think about the last really good experience you had. What was it about the experience that made it so positive? Now think about the last horrible experience you had. What was it that made the experience so poor? I’m betting that the factors behind why your experience was positive or […]

Posted in Kiriworks Blog | Tagged , , , , , , , , | Comments Off on Building a Strong Network: It Takes an Empowered Team

The Secret to Improving Member Experience? Hint: It’s Probably Not What You Think.

Life is full of different experiences. Take a moment to think about the last really good experience you had. What was it about the experience that made it so positive? Now think about the last horrible experience you had. What was it that made the experience so poor? I’m betting the factors behind why the experience was positive or negative […]

Posted in Kiriworks Blog | Tagged , , , , , , , | Comments Off on The Secret to Improving Member Experience? Hint: It’s Probably Not What You Think.

Digital Transformation in Manufacturing: Getting You Ready For Race Day

A couple years ago when I started thinking about running my first half marathon I knew it was going to be a real project and a real commitment. See, running doesn’t come easily or naturally to me and I don’t hesitate to say I’m usually bringing up the rear in most of my races. Although I’ve been an athlete my […]

Posted in Kiriworks Blog | Tagged , , , , , | Comments Off on Digital Transformation in Manufacturing: Getting You Ready For Race Day
Kiriworks Like, Follow & Share:
February 9, 2018

Be an Olympic Athlete in the Work Place

The Winter Olympics are here! If you’re like me, you’re looking forward to the excitement and thrills of international competition! I am a snowboarder so I have a personal love for winter sports and will be glued to my TV and social media feeds watching the events and keeping medal counts. There is such an inspirational culture built at the […]
December 11, 2017

PAIN…a sign that change is near.

What is pain? Pain is physical suffering or discomfort caused by illness or injury. Pain motivates you to withdraw from damaging situations, to protect your body and to avoid similar experiences in the future. How many times do we have pain but ignore it? I know I have. I was running a 5K and BAM about half way through I […]
August 31, 2017

Things That Are Better Together

There are many things in this world that make us happy and bring us joy. Sometimes when those great things are combined with other wonderfully, great things they become AMAZING! Simply put…they are Better Together. Here are a few of those amazing things: Peanut butter and jelly Milk and cookies – especially chocolate chip! Netflix and your couch Danny and […]