Roster Automation—Not Just an Upgrade—Complete Transformation of Provider onboarding

Provider onboarding is more than just paperwork—it’s the foundation of smooth-running healthcare system. Unfortunately, traditional processes are often slow & sluggish and struggle to keep pace with today’s demands for speed, accuracy, and compliance.

The consequences are real!

Onboarding delays not only frustrate providers but also create a ripple effect of challenges, including:

• Hindered care delivery
• Errors in provider data
• Compliance violations
• Billing issues

Understanding with a Use Case

A new provider joins your health plan and is really willing to deliver quality care. However, instead of a frictionless onboarding experience, he’s just too overwhelmed with never-ending paperwork, delays, and back-and-forth communication.

Unfortunately, this scenario is all too common in healthcare today.

For modern health plans, efficiency and precision matter the most and thus, there’s a pressing need to efficiently manage the onboarding process. McKinsey’s 2023 report says that offering consumers with the experiences they expect at every stage of the healthcare journey substantially improves care and cost outcomes. That’s where roster automation comes into the play. Roster automation is not just an upgrade—it’s a complete transformation of how health plans handle provider onboarding. Let’s understand why roster automation matters and how optimizing the onboarding process can help in the way health plans handle onboarding.

Decoding the Barriers of Manual Processes

Managing large volumes of provider data is a big-time task, particularly with evolving regulations and the demand for timely updates. Manual processes, once the standard, are now a bottleneck. Here’s why:

• Delays in Onboarding: Manual processes are slow and inefficient, they don’t only frustrate providers—they slow down care delivery and network expansion
• High Error Rates: Manual data entry is a minefield of mistakes, and the impact is serious. It often leads to compliance violations, billing issues, and dissatisfaction among providers

A Smart Solution: Roster Automation

Roster automation is more than a buzzword or a trend—it is a transformative solution. A robust roster automation helps swap outdated manual methodologies with intelligent automated systems and empowers health plans to overcome process inefficiencies in multiple ways. Let’s understand how it operates and benefits that it offers:

1. Streamlined Provider Onboarding and Maintenance

Onboarding does not have to be a headache. Automation changes the game:

• Using artificial intelligence (AI)/ machine learning (ML) technologies to standardize unstructured provider rosters, making them ready for seamless integration into provider data management (PDM) systems. You can think of it like upgrading from a typewriter to a laptop—suddenly, everything becomes faster, smoother, and more efficient

2. Reduced Errors and Improved Data Consistency

Manual data entry is the breeding ground for mistakes. Whether it’s missing a credential or entering the incorrect data, even small errors can snowball into big problems, such as compliance violations and billing disputes. Roster automation solves this by:

• Ensuring accurate provider data—names, specialties, and credentials—is captured with accuracy right from the start
• Maintaining consistency across systems, which is essential for meeting CMS, Federal, State, and other NCQA guidelines

The result? Fewer headaches, fewer compliance risks, and happier providers.

3. Scalability and Flexibility

As healthcare organizations grow, so does the complexity of managing their provider networks. Manual methods, which might have worked for smaller networks, quickly become overwhelming as the volume of providers expand.

Roster automation, on the other hand, is built to scale. Whether adding dozens or thousands of providers to the network, roster automation tools can handle the increased volume without compromising on performance or accuracy. Automation tools are highly scalable, allowing health plans to efficiently manage larger, more complex provider rosters, even in the face of new regulatory requirements

4. Better Provider Experience and Satisfaction

First impression counts. A slow or inconvenient start leave a lasting negative impression. Roster automation expedites the process, making it easier for providers to join the network quickly. Features automatic integration with provider data management systems keep providers informed about credential renewals, contract changes, and other critical updates, encouraging better communication and stronger relationships

5. Cost-saving and Resource Efficiency

Manual onboarding and maintenance are time-consuming and resource-intensive. Automating these processes helps health plans reduce administrative costs, allowing staff to focus on higher-value tasks. Moreover, automation minimizes costly errors, such as mistakenly including unqualified providers or missing regulatory deadlines. Health plans that leverage automation can realize significant cost-saving, especially as the industry evolves and faces increasing pressure to maintain profitability while delivering quality care

Driving Success with an Ideal Automated Roster Solution

Given here are some of the core capabilities of an ideal roster solution that help health plans meet their goals:

1. Automated Data Entry and Integration

   Automatic capture and integration of data from multiple sources, such as provider applications, databases, and external systems eliminate the need for manual data entry, minimizing errors and the administrative workload

2. Robust Integration with Core Provider Systems

   Roster automation works hand-in-hand with other health plan systems, including claims processing, credentialing, and other core payer systems, minimizing manual data reconciliation

3. Scalability and Flexibility

   Whether it’s about onboarding dozens or thousands of providers, automation tools are scalable and flexible. These tools can easily accommodate changes in provider volume, network expansion, and evolving regulatory requirements

4. AI-powered Predictive Analytics for Field Mapping

   AI/ML tools transforms unstructured provider data into standardized formats, dramatically speeding up the process of onboarding new providers and improving accuracy

Empower Your Health Plan with Newgen’s Roster Automation

Roster automation is the future of healthcare. With Newgen’s roster automation—part of our Provider Lifecycle Management Solution—you can:

• Effortlessly ensure, up-to-date provider data
• Deliver a smoother onboarding process
• Improve efficiency
• Scale operations while ensuring compliance adherence

Ready to transform your health plan? It’s time to embrace the future—automate with Newgen, today!