Provider Lifecycle Management

A Robust Scorecard

Harnessing our in-house domain expertise and strategic technology partnerships, our solution consistently delivers winning outcomes:

~80 percent reduction in provider onboarding time
Upto 85% reduction in manual effort and improved throughput in provider data management
USD 3-5 Mn potential savings (regional payers) and USD 8-10 Mn (national payers)
Enhanced member satisfaction with increased data quality

Enabling Providers At Every Stage

WNS’ comprehensive PLM capabilities offer an array of solutions that streamline and elevate all aspects of the provider life cycle.

Prospecting

Identifying and recruiting physicians

Proactive lead management to engage provider prospects
Collection and analysis of provider details
Enrollment and onboarding of providers

Contracting

Contract completion and set-up

Mapping pricing structures based on services offered
Application of provider discounts
Timely issuance of welcome and contract letters to providers
Swift issuance of termination letters for sanctioned providers

Credentialing

Validating physicians’ credentials

Creation of provider profile
Primary Source Verification (PSV) and Council for Affordable Quality Healthcare (CAQH) verifications
Periodic re-credentialing reviews
Ongoing provider follow-ups

Configuring

Setting up within the system

Physician demographics
Agreed upon service details integrated into downstream systems and directories

Servicing and Data Management

Managing the source of truth for provider data

Provider data management – add, update term requests
Roster management and mass updates
Generation of extracts for web and print directories
Continuous, vigilant sanction monitoring through portals

Success Stories

Unlocking Efficiency in Healthcare Provider Support

For a leading North American payer, we spearheaded provider data management for a network of 2,500 healthcare professionals across the continent. Our solutions encompassed initial credentialing, seamless onboarding, re-credentialing strategy and a responsive provider support helpline via both voice and e-mail.

The Results

Redefined provider experience through meticulous initial credentialing and seamless onboarding leading to 100% data accuracy. Achieved an outstanding 98.5% provider satisfaction, reflecting operational success and automation impact.

Maximizing Performance Through a Global Center of Excellence

For a global insurance major, we established a dynamic global center of excellence, offering a diverse spectrum of services. This included seamless provider registration and onboarding, robust directory maintenance, efficient payment processing, vigilant monitoring and sanctions management and specialist care coordination.

The Outcomes:

A 59 percent decrease in member inquiry calls, a 39 percent boost in annual recoupment and a 5 percent reduction in incoming calls for specialist inquiries.

The WNS Advantage

11+ payer clients
400+ PLM staff
1.5 million+ facilities covered
50.0 provider NPS score vs. industry average of 18.0
750 million+ annual provider records managed
16+ years of provider management experience
>98 percent provider satisfaction scores
~78 percent provider web adoption across clients