Providers Partners Health Plan (PPHP) is a new Medicare Advantage plan designed to provide Medicare beneficiaries residing in long-term care facilities with coordinated care by partnering with their local care teams.
As a CEO, I never want to hear about credentialing, just like I never want to hear about issues with the Internet or the copy machine. I just want it to work. It’s important to get credentialing done right, but from a strategic perspective, it doesn’t grow the business, so I also don’t want to spend a lot of money on it. I feel great working with CredSimple, because Dana, who leads our credentialing function, is happy and satisfied. When she is happy, so am I. The last thing a CEO wants is to be involved in the credentialing process.
As a new plan, PPHP needed to quickly create a strong network of providers and get them credentialed in time. They wanted a fast, accurate and cost-effective solution that didn’t require much attention and instead allowed them to focus on strategic growth. In creating PPHP’s credentialing function from scratch, Dana Guidera knew she needed to hire a CVO that would provide reliable service and return compliant provider files that were easy for her new team to digest. The CVOs she had worked with in the past returned messy and inadequate files that would frustrate her team and require hours of digging through data to find what they needed to present to the credentialing committee. Dana was looking for a new kind of CVO that would make her team’s job easier.
Because CredSimple’s CVO service is user-friendly and reliable, Dana has been able to build a streamlined credentialing process that works with PPHP’s business operations. Further, she will only need to hire 1 or 2 credentialing staff in every region instead of the 3 or 4 she would have needed if they had to manually parse out the data received back from their CVO.
As a trusted partner, CredSimple doesn’t distract Dana and PPHP CEO Rick Grindrod from focusing on strategic growth and meeting its goal to provide its members with the best coordinated care possible.