This article is part of a series in which we interviewed 3 seasoned provider network development experts with decades of experience building high quality provider networks for health plans.
Our conversations with Mary, Mike and Leslie yielded several insights and tips into building a stronger provider network. (Names have been changed for privacy)
In our third installment of this series, we’re going to take a look at how training providers to effectively and efficiently utilize their new health plan network can make all the difference. But before we get there, let’s recap a bit:
- In our first installment, we talked about the various lessons that we’ve learned throughout our time as network developers –it’s more than just a service. In addition, organization and constant reporting are the key ingredients for the recipe of success.
- In our second installment, we discussed how a good network developer understands just how to navigate the industry by offering tiered representatives to clients, keeping representatives around after the project is complete, and just how to leverage your power as a network developer to meet 2nd-level needs.
Today, it’s time to see discuss the critical role of training providers and their staff on how health plan claims processing rules work for you particular network.
Pre-Network Standup Provider Training
Training providers on how to use your network prior to actually developing it is just as important as training them to use it once it’s complete. For a number of different reasons, your providers need to know what they’re getting into before they get into it.
For instance, providers should easily and clearly understand billing rules, documentation, contracting, and more before and during the network development process. They need to have a clear understanding how typical office staff may respond to different stages of claims submission processes.
It’s also important to set expectations upfront during the network development stage, that way all health plan staff responsible managing the network after it’s been developed are aware of how their network will function. Things like payer classifications and billing and claims reportsshould all be discussed prior to development completion.
We mentioned in our last installment just how important post-development support is. However, post-development training is also an important factor. Being around to not only support the network that you’ve developed, but to also train the workers who are going to be using your network will help to set your process apart from other network developers.
This can be offered along with a post-development support/maintenance package, where you can onboard and train new employees on how to use the network, generate reports, billings, claims, and so much more. The key aspect to take away here is this – go above and beyond for your clients.
Keywords: Insurance, Health Insurance, Network Development, Network Developers.
Need help building your network? Or implementing new tools to empower your in- house team?
Here at Paragon Technology Partners, we combine best-in-class technology with best-in-class services to help a wide range of clients. In addition to network development, we also provide solutions and services designed to help providers and payers meet the ever-changing needs related to population health and value-based care. Reach out today to learn more about how we can help.