Provider Portal Provider Portal

Built for your Health Plan, TPA, or IPA

Efficiently communicate and disseminate information and documents to your physician network.
Provider Portal Claims
Allow providers to easily submit claims and view claims status
Provider Portal Authorizations
Enable providers to submit authorizations and view auth status
Increasingly, physician practices expect their health plan partners to offer a provider portal that allows them to: 1) submit authorizations and referrals, 2) view claim status, 3) confirm payments, and 4) check member eligibility. Health plans have traditionally relied on EHR add on modules that typically offer limited functionality, poor interfaces, and lack of integration to other applications. This reflects poorly on the health plan, resulting in lower physician satisfaction and creating an ongoing burden on internal staff still working with providers that do not utilize the portal.

Enter Your Customized Provider Portal

We leverage our extensive domain expertise and our ability to create a custom solution efficiently that results in the highest provider utilization and satisfaction. Example client results:
  • Surgical referrals increased from 0% to 83% in less than 6 months*
  • 100% f claim status and payment status via provider portal in 3 months**
  • Email and fax-based provider interactions decreased by 85+% and replaced by inquiry forms, notices and chat.*
  • Increase from 30% to 80% of physician network utilizing provider portal*
  • 50% decrease in billing errors**
* TPA Results
** TPA and Health Plan Results

Provider Portal Core Features

  • Review and Approve Claims
  • Show Member Eligibility
  • Referrals Authorization Management
  • Review and Approve Provider Enrollment Applications
  • Provider Manual
  • Create Provider-Focused Email Templates
  • Chat Feature Allow Documented Communication between Provider and Health Plan Staff
  • Document Management
  • Custom Dashboards
  • Custom Reports
  • Permissions Management
  • Manage Physician and Vendor Rosters

INCREASE THE PRODUCTIVITY OF YOUR PROVIDER SUPPORT TEAM

Provider Portal Support
ADDITIONAL FEATURES MAY INCLUDE:
  • HEDIS recommendations
  • Provide Evidence of Payment (EOP) summaries
  • Single Sign On with other systems
  • Gather Provider Feedback with Provider Survey Module
  • Provider Quality Reporting Module
Free up your provider support staff’s time and increase efficiencies by utilizing a provider portal designed for your type of organization (Health Plan, TPA, or IPA).

Custom Provider Portal Benefits

  • Dramatically reduce your staff’s provider support time
  • Allow provider self-service for claims, payments, authorizations and more thereby increasing provider satisfaction
  • Reduce multiple channels to a single channel of communication
  • Provide better auditing of requests, responses, and staff interactions
  • Provide consistent and reliable communication, reporting, and feedback
Tailored Apps. Real results.

Interested in working with Serious Development?

Contact Us