Six Best Practices for Automated Provider Enrollment Programs: Case Study

In the past two years, PhyMed Healthcare Group, a physician-led and owned leader of anesthesia and pain management services in Tennessee, Kentucky, and Pennsylvania, has undergone major transitions to improve their provider enrollment process. With the help of an VerityStream consultant, the PhyMed provider enrollment team was able to break out of a cycle of low system utilization, excessive write-offs, and poor revenue cycle management. PhyMed’s provider enrollment system transformation is a success story that highlights problems many companies face and offers creative, accessible solutions to common challenges.

How to Get the Most Out of EchoOneApp for Automated Provider Enrollment

The following list of best practices recaps the action items that led to PhyMed’s having a more effective program:

1. Using EchoOneApp to its full potential. Make this goal a priority. Within the EchoOneApp tool there are countless enhancements to use and a library of more than 3,800 mapped payer forms that will automatically populate data from a provider’s or group’s record. Prior to consultation with VerityStream, PhyMed had never downloaded a single form. Using these payer forms allows for the applications to pull information stored in the system, cutting out hours of time spent populating forms by hand.

2. Going paperless. Once you are using the software appropriately, there is no need for a paper system. We recommend that you implement a no-paper rule for your team. This can be a major culture change, as many people view a paper system as a safety system. However, making this shift toward paperless processing allows a team to focus their time more efficiently and effectively.

3. Incorporating payer enrollment into provider orientation. During provider orientation, it helps to have a designated day for the payer enrollment team to go through all required paperwork, ensure that they have everything they need from providers, and get all applications signed. From there, the team is able to determine a close start date so that they can immediately begin enrolling new providers.

4. Writing memos to close gaps. To end a cycle of unresolved write-offs, engage your compliance officer to write some memos to close the gaps.

5. Attending privileging meetings. Ensure that someone on the enrollment team is able to attend privileging meetings, allowing you to stay informed of the latest changes surrounding privileging.

6. Creating a payer enrollment sheet. The creation of a simple document explaining the role of the payer enrollment team and what is going to be needed from providers can eliminate confusion and set expectations for providers

This blog post excerpts an article in the Q1 2017 Provider Advisor, where we discussed PhyMed’s provider enrollment program turnaround in greater detail. Complete the form below to download the entire issue.

April 1, 2021