The Challenge
- Staffing and retention challenges that resulted in issues with validation and accuracy of provider panels
- Limited network management resources available to accommodate the expected turnaround time for updated provider panels
- Limited network management resources available to capture the network provider fluctuations (retired, deceased, no longer accepting workers’ compensation patients)
- Client seeking single-source solution to assume provider validation and panel card creation for mandatory and non-mandatory states
The Solution
- All Panel Card Coordinators are full-time Shearwater Health employees
- All Panel Card Coordinators are either U.S. or Philippine RN’s with prior call center/voice experience
- Shearwater Panel Card Coordinators validate 100% of providers prior to panel placement
- The use of Shearwater’s productivity tracking tool, TotalView™, to manage efficient workflows
- BSN Registered Nurses with prior call center/voice experience
- Provider validation and creation of panel cards for all mandatory and non-mandatory states
The Strategy
Close Network Provider Coverage Gaps
Staff Reduction and Reallocation to Complex Processes
Increased Turnaround Time Compliance for Provider Panels
100% Accuracy for Provider Validation Prior to Placement
The Results
2X
Shearwater doubled volume within months of implementation
99%
Quality Scores rise above expectations
20%
Cost Savings with Full Prep Model
