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. BCBS enrollment requires the provider's contracts to be retrieved, named to a specific convention, packaged, and submitted, and a delay here pushes out the enrollment date, which directly drives charge write-offs when service dates fall before the enrollment date. Doing the retrieval, renaming, and packaging by hand is slow and error-prone.

Automation Solution

This automation retrieves provider enrollment contracts from MD-Staff, renames and organizes them per BCBS naming conventions, packages them into a zip file, and submits them to BCBS for processing, supporting timely enrollment and reducing write-offs from mismatched service and enrollment dates.