The Best Platform For A Network of Surgery-Based Providers

Managing a Specialty Network of Surgery-Based Providers

From general surgery to neurosurgery, providers rely on a lot of paperwork to keep their practice running. After all, specialized services require extensive coordination between primary care providers (PCP), clearinghouses, and payer organizations on a daily basis—all of which ultimately leads to piles of paperwork and tons of administrative costs. 

Luckily, there are all-inclusive software like QuickCap 7 that have all the tools you need to simplify your management and administrative workflows. Find out how the best management platform can help you and your surgery-based providers improve your specialized or specialty network.

What Surgery-Based Providers Really Need

What if going digital could help you reduce administrative costs and improve overall outcomes in one go? Numbers don’t lie, and the difference between manual transactions and electronic data interchange (EDI) could help your organization save thousands of dollars in the long run!

According to a UnitedHealthcare, health plans generally spend $2 more on manual transactions than they would on EDI transactions. Similarly, providers can cut an average of $4 dollars off their transaction expenses by utilizing an electronic platform.

From eligibility verifications to claim payments, EDI services alone can help payers and providers save hundreds of dollars in administrative costs—and that’s only the tip of the iceberg. Some of the best management platforms have more features that both providers and payers can enjoy.

Here are some of the essential features you need to look for:

• Adaptable EDI and Electronic Health Records (EHR) Services. Different providers have different operational requirements. This means you need a platform that can accommodate any type of EDI or EHR file formats that your providers send. Remember, your advanced system can only go as far as the files that it can process.

• Customizable Contracting, Pricing, and Payment Features. Specialists have their own unique requirements, and having flexible contracting capabilities allows for on-point pricing for each of your providers.

• Dedicated Care Coordination and Case Management Tools. Surgical procedures require a lot of smooth coordination between PCP, care teams, and specialists. Having a dedicated case management module allows for easy tracking of high-risk patients, quick access to health records, and ultimately better patient outcomes.

• Advanced Authorizations, Referrals, and Claims Processing Capabilities. If you want faster turnaround time and accurate processing, you need the best tools available. A system with built-in automation features means faster processing and more accurate results, so you can reduce staffing costs and avoid manual errors.

From ease of operations to administrative cost reductions, having the right platform ensures better outcomes for both specialist providers and payers alike.

QuickCap 7, the All-in-One Software You Need

QuickCap 7 is an online management platform that has all the tools you need to manage a specialty network. Whether you’re handling hundreds of surgery-based providers or managing a wide array of medical specialists, QuickCap 7 is fully adaptable to your specific needs.

Remote Access to a Centralized Platform

• Store your essential business data in one secure platform that allows for easier healthcare data transactions.
• Give your providers remote access to information like authorization requests, pending referrals, and ongoing claim adjudications—everything your providers need is right at their fingertips.
• Use one platform to view and update important data like eligibility rules, health plan contracts, benefit plans, member information, practitioner profiles, eligibility, and more.

Extensive EDI Transaction and Case Management Features

• Experience the convenience of having a fully adaptable EDI system that allows you to share and receive files from various partners.
• Customize your trading partner details, set up specific EDI configurations, and adapt to client-specific file requirements.
• Utilized a dedicated case management module that allows you to track high-risk cases, establish cost-effective care plans, collaborate with care teams, and more.

Comprehensive Contracting, Billing, and Payment Functionalities

• Accommodate special contracting requirements for fee-for-service payment models, capitation arrangements, copays, deductibles, and more
• Fully configure your pricing rules for accurate and timely billing
• Automate crucial processes authorization reviews, referral approvals, and claims adjudication

Dashboard, Analytics, Audits, and Reports

• Access user dashboards that make data gathering and visualization as easy as clicking a button
• Document every crucial detail in your system like reviewer notes, member information updates, contracting changes, pricing adjustments, and more
• Analyze critical information using various reporting tools like a personalizable query builder for specialized data reports

Having full control over every aspect of your specialized network is essential for success. QC7’s broad features provide the tools that you need to empower your business and stay ahead of the competition.