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.

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New Innovations: Provider Outreach

The software industry today is a diverse and dynamic industry with products readily available to meet just about every business need imaginable.  But what do you do when you need a product that can send thousands of surveys, attestations, or general outreach to your providers?  What options are you using when you need the data to be returned to your […]

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The 10-Year Challenge

The most recent social media trend has been the 10-year challenge, when an individual posts a picture on a social media platform like Facebook, Instagram, Snapchat or Twitter, and compares a picture of themselves from 2009 to 2019. Which typically sparks a conversation between followers and friends of how so much has changed within the 10-year time span.   2009 to today has […]

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Don’t listen to what they say – GO SEE.

Greetings and welcome to 2019!   As you begin planning your new year and accomplishing goals, we wanted to share with you some upcoming healthcare related conferences we will be supporting in February, March and April. First we’re looking forward to getting out of the Cleveland winter and heading to at HIMSS19 in Orlando, Florida.  Seema Verma and Alex Azar will […]

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Submit or Not to Submit? That is the AOR question.

Appointment of Representative, (aka the AOR) always seems to be a topic of conversation in the healthcare payer space. Every show we attend, every customer we talk with and every industry function we attend, there are intense conversations and differing opinions on what is required by CMS. Do you only submit an AOR once? Do you need to submit a […]

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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 […]