Problem Statement

Providers must be enrolled and credentialed with payers before their services can be billed, and a provider who isn't enrolled in time generates claims that deny or get written off. Managed care payers require a delegated roster in a specific format, which means combining provider master-file data from the EMR with credentialing data from a separate system each month. Assembling and reformatting that roster by hand is repetitive and error-prone, and a late or incorrect roster delays the payer recognizing the providers.

Automation Solution

This automation combines the monthly provider Masterfile (SER) export from Epic with credentialing data from Echo into the delegated-roster format required by managed care payers.