Provider
Management 

Your physicians’ and providers’ information does not stay static; it is always changing. Keeping that information up to date can be a daunting task. However, it’s crucial for maintaining seamless member access to your provider network. Everise takes the burden off your shoulders, managing the changes to provider information, effectively keeping your network current. This ensures your members find accurate information when searching for a provider, avoiding unnecessary out-of-network detours and improving member satisfaction.

Expanding your provider network is critical to growth. Everise can help grow your network by managing the discovery and enrollment of new providers. From initial outreach to qualify and capture the enrollment information, to generation and submission of the enrollment form, through to following-up on each submission, making any necessary corrections, Everise efficiently manage the process of quickly bringing new providers into your network.

The length of time between billing and payment can be a source of confusion for providers. Payments can often be held up due to missing information or complex procedures that require additional review. This means a provider may not have a clear understanding of when to expect payment. This can generate inquiries from a provider, requesting information on payment timing. Our team of expert agents is here to respond by dealing with any requests and issues that arise, helping to walk the provider through the payment process and timing, and helping to set expectations of when a payment can be expected. This transparency helps maintain good relations with your provider network.

A times, a provider may not agree with a billing payment decision. Managing the formal appeals and grievance process takes a delicate touch. The Everise agents are well versed in both a clients’ billing and payment criteria as well as effectively managing potentially contentious situations with empathy and professionalism. From clearly explaining any billing issues, to helping with the appeal, our team helps to reduce the friction and speed up the outcome.