Provider Engagement Services
Improve provider experience and
increase network access.
Acentra Health's provider management module streamlines the provider enrollment experience with a configurable intake application. Our secure, scalable module seamlessly connects with public and proprietary data sources to verify provider credentials and eligibility instantly. Reviewers can approve, deny, or suspend applications through a single interface. Providers have portal access to update data and perform self-service tasks. Built on Acentra Health’s evoBrix X™ technology, the provider module is CMS certified, National Institute of Standards and Technology (NIST) compliant, and meets federal and state regulations.
Secure and validate providers to ensure better health outcomes
Our provider engagement services suite improves provider and payer relationships through digital enrollment, automated screening, self-service maintenance, and site visit data. The data verification and approval flow begins as providers submit their professional identifier information into the enrollment application. Before providers are enrolled, the Provider Credentialing Service (PCS) module verifies licensing and uncovers any sanctions in place, to help safeguard members. The provider management solution automates revalidations and license renewals, allowing providers to update and maintain their qualifications and professional information.
Digitally enable and engage providers to
submit required data
Acentra Health's digital provider solution includes a configurable rules-driven application to quickly and easily gather providers’ data online. The provider screening and review processes are streamlined and automated, reducing approval turnaround time and minimizing manual data verification. Continuous system monitoring and maintenance ensures providers remain program compliant. Automated revalidation saves providers time and effort during periodic re-enrollments and helps to improve the provider experience and related networks.
Easily intake relevant data
and documents from
providers
Offer assistance rapidly
with context-specific online
help and chat support
Reduce time needed
for pre-screened application
reviews with configurable
workflows
Instantly communicate online
changes in claim status
and outcomes
Optimize and automate
verification and compliance
of enrolled providers
Update configurations to
reflect changes in policy or
practice in real time
Provider Maintenance
Acentra Health’s provider engagement service provides continual screening and monitoring to ensure providers comply with policies and meet program standards. Payers can manage individual providers in networks, while seamlessly exchanging provider data with other modules on the evoBrix X™ platform. Providers can update their information, delegate access, and complete other maintenance tasks aligned with program requirements. The system revalidates provider enrollment information with pre-filled applications that increase response rate and help maintain provider network adequacy.
- Online portal for providers to view and update their information and credentials
- Monitor providers to ensure ongoing program compliance
- Automate revalidation of existing providers and contract
Provider Screening
As part of the provider engagement services, Acentra Health’s Provider Credential Service (PCS) performs automated provider screening, displaying all results together on one interface. Results lists show validations and exclusions to save administrators time performing manual look-ups. The PCS database stores processed requests and responses for a comprehensive historical data view to be used for necessary audits. The PCS includes all ACA-required screenings for provider and owner verification. Solution implementations can include criminal records and Medicare Provider, Enrollment, Chain and Ownership System (PECOS) data. State programs that require Managed Care universal credentialing can integrate the PCS solution with a Credential Verification Organization (CVO).
- View provider screening results in one location
- Access historical screening data to support audit requests
- Obtain critical data, such as criminal records, to improve member safety and prevent program abuse
Provider Enrollment
Our provider enrollment solution rapidly acquires provider data online. To expedite the screening process, verifiable content is checked during provider data entry. The enrollment form is customizable to client policy needs, ensuring the provider enters all required, relevant information. Configurable workflows route the application post-submission, minimizing reviewer efforts and accelerating automatic approvals and denials. Additionally, Acentra Health’s mobile-compatible Site Visit Pro solution enables payers to submit findings on site visit data.
- Decrease returned applications through submission verifications to ensure all required documents and data are included
- Enrollment can be completed within minutes; easily save in-process applications and resume the process when ready
- Automatic revalidation assistance made available to providers
Approved Supplier Partner Of NASPO ValuePoint
Acentra Health is a supplier partner of the MMIS Provider Services and Claims
Processing and Management modules for state Medicaid programs.
What Our Partners Say About Acentra Health
"With this full approval from CMS for [the evoBrix™ Provider Management module], AHCCCS [Arizona] and Med-QUEST [Hawaii] are now poised to be able to streamline the provider enrollment process, improve the providers’ user experience, and eliminate previous manual enrollment processes. Moving to this cloud-based solution is one more step toward modernizing the technology we use to provide health care services to the nearly 2.2 million Arizona residents and 430,901 Hawaii residents enrolled in Medicaid.”
— Kristen Challacombe | AHCCCS deputy director of business operation
"We needed to replace outdated technology, which was inefficient to modify and had high maintenance and operation costs. We are pleased to have met our goal of implementing a new solution quickly with very little disruption to our providers and appreciate the dedication of the state staff working on this project with [Acentra Health]."
— Teri Green | State Medicaid Agent and Healthcare Financing Division Senior Administrator, Wyoming Department of Health
"The [Acentra Health] team has consistently provided fantastic service and support throughout numerous initiatives. Not only did they complete required tasks on time, they also proactively identified a business need and delivered new visualization data to help us better track encounter data submissions. [Acentra Health’s] commitment and dedication to the CMS mission is evident and much appreciated."
— Contract Office Representative, Centers for Medicare & Medicaid Services (CMS)
Blog
Get the recent download on industry topics, program overviews, timely policy updates, and thought leadership conversations.
White paper
Check out our selection of whitepapers to learn more on how our services and solutions work and how they could benefit you.
News & Events
Stay connected with Acentra Health’s latest news and view upcoming industry events for the opportunity to connect with our team in-person.
Get Started with Acentra Health
Connect with an expert from our team and learn more about how
Acentra Health's solutions and services can benefit your organization.