Silverline Healthcare: Provider Network Management · at the Silverline ASC. Alice Abrams is an...

Silverline Healthcare: Provider Network ManagementJim Rogers, RN, BSNDirector, Healthcare [email protected]

Matt Gretczko, VP, Head of Healthcare

[email protected]

SILVERLINE HEALTHCARE AND LIFE SCIENCES

Who is Silverline: Fast Facts

Salesforce Certifications FoundedSalesforce ProjectsResources Assets & Accelerators

Locations⬤ Headquartered in NYC ⬤ Offices in Chicago, Orlando, Omaha,

Minneapolis and Bangalore (India)⬤ Resources around the globe

Customer Satisfaction

1,100+350+ 175 400+ 4.8/5 2009

Accolades

Salesforce Certifications

ExpertiseHealthcare

• Provider • Payer • Biotech/Life Sciences • Medical DeviceFinancial Services

Platform

Silverline Key Informationo Sole platform focus is Salesforce

o Dedicated Healthcare Practice - Advisory, Presales, Delivery, Support

o 2019 Salesforce HLS Consulting Partner of the Year

o 2018 Salesforce Partner Innovation Award

o Dedicated focus on Health Cloud; Continued Alignment to Roadmap

o Technical, Functional, Operational, and Clinical Healthcare Expertise

o Glassdoor 2018/2019 Top 3 Nationally Recognized Best Place to Work

pilot partner


Provider Roadmap: Enabling Patient Engagement Success

PROVIDER RELATIONSHIP MANAGEMENT

CONSUMER & PATIENT

ENGAGEMENT

AMBULATORY CARE COORDINATION

TRANSITIONSIN CARE

SPECIALTY CARECOORDINATION

Build Provider & Clinic/Facility Profiles

Manage ACO & Integrated Networks

Create Tiered System Relationships

Track Onboarding & Credentialing

Provider Program Participation

Provider & Care Team Engagement

Patient Access Center

Referral Navigation

Concierge Care Models

Symptom-Based 24/7 Nurse Triage

Targeted Patient Education

Patient Engagement Journeys

Track and Manage Risk & Cost

Coordinate Care via Care Plans

Complex Care Management (CCM)

Care Gaps Management - HEDIS

Medicare Innovation Program Management

Ambulatory Care Journeys

Manage Acute Discharges to PCP

Transition Care Management (TCM)

Proactive Readmission Prevention

Discharge Assessment & Triage

Step-down Care Management

Post-Acute Patient Journeys

Patient Community for Onboarding

Oncology Navigation Programs

Joint Replacement Programs

International/Travel Care Models

Bariatric Surgery Programs

Care Management Patient Journeys

© Confidential - Silverline - Do Not Distribute


○ Agent/Role-Driven Patient 360

○ Dynamic Call Routing, Call Scripting, Task Management

○ Omni-Channel Engagement

○ Scheduling Management

○ Referral Management

○ Next Best Offer/Action

○ Context-Specific Knowledge

○ Provider/Facility Search

○ RSVP - Campaign/Event Registration

The foundation for patient engagement begins with an agent workflow-centric access or contact center and a 360° view of the patient. Maximizing member engagement requires omni-channel communication, and the introduction of patient journeys.

Access/Contact Center○ Align communication to “best” or

“preferred” channel

○ Consumer to Patient Conversion

○ Patient Loyalty and Satisfaction

○ Condition-Specific Knowledge Enablement

○ Patient-Centric Wellness Journeys

○ Billing/Claims Status Updates

○ Care Pathway Engagement

○ Mobile and Community Engagement

○ Longitudinal Care Timeline View

○ Data Analytics-Driven Risk Scoring

○ Real-time Care Gap Identification and Mitigation

○ Chronic Condition Care Management

○ Dynamic Care Plan Templates

○ Cost Avoidance Strategies

○ Social Determinants Integration

○ Manage Care Transitions

○ Service Line Care Management Pathways

Patient Journeys Care Management

© CONFIDENTIAL - SILVERLINE - DO NOT DISTRIBUTE

Our Patient Engagement POV

© CONFIDENTIAL - SILVERLINE - DO NOT DISTRIBUTE

Silverline Healthcare

Provider Network Management


The successful result of this is two-fold: ● Create continuity of care for your patients to increase efficiency and effectively track quality● Increase opportunities to retain downstream revenue within your network

The key to defining your provider network in a manner that impacts your patient navigation is to build and maintain provider and clinic profiles that go beyond the traditional credentialing data to include: ● Services provided in the clinic● Procedures performed in the clinic and the outpatient setting● Locations with directions, parking instruction, and public transportation routes● Scheduling rules or restrictions at the provider, clinic or insurance level● Up-to-date notifications on provider availability


Creating and defining your provider network is a critical first step in managing patients and navigating them within your healthcare system. Whether you are a clinically integrated network (CIN) or an accountable care organization (ACO) you must manage referrals from primary care to specialty care and services within your healthcare system.



Silverline’s Provider Network solutions typically include: ● Manage contract requirements, compliance, and milestones ● Create and manage the providers and clinics in tiers, (relationship between the provider and the

healthcare system)● Safe harbor scripts to inform the consumer/patient of the relationship between the provider and

the healthcare systemOne unique approach to provider network management is to manage the onboarding process for providers and clinics in Salesforce. ● Tracking the HR, IT, Telecom, Real Estate, Legal, Credentialing, and other processes● Individual departments to collaborate and simplify communication ● Introducing the provider to the new network and the network to the new provider● Change referral patterns and increase in-network utilization before their go-live date.


It is also important to track provider participation in your individual ACO’s, risk-based programs, and value-based programs. Some providers in your network may be employed, while others may be members of your CIN/ACO or be on active staff with a healthcare facility.



Provider Relationship Managers, sometimes called Physician Liaisons, are valuable members of the provider network but often lack the tools to effectively communicate and track their relationship with providers or collaborate with others calling on providers or clinics.

There are several options for creating and managing this communication network:1. Utilize standard Salesforce Health Cloud functionality to build and maintain provider and clinic

profiles including email templates, surveys, lead and opportunity management and mobile access to records.

2. Add Marketing Cloud to enhance communication via journeys for provider acquisition, onboarding and targeted communication.

3. Create a Provider Community to share information directly with providers and clinics, facilitate document sharing, enable direct updates of profiles and access to the shared provider and services directory. This can also support a referral management workflow.


Engaging with providers in your network is critical to increasing quality and enhancing the patient experience.



Provider Network ManagementAlignment to Health Cloud Provider Data Model is Critical



Referral Management Demo

Maria Gonzalez is a 28 year old newly expectant mother who is married and lives in the city.

Jennifer Bosworth is provider specializing in Women’s Health Services.

● She practices at two clinics and provides 5 different services.

Lauren Weiss is a primary care physician with United Physicians Group.

● She participates in two ACO programs.

George Borgrave is a bariatric surgeon with United Physicians.

● Her performs his surgeries at the Silverline ASC.

Alice Abrams is an oncologist with Silverline Oncology.

● She is the Medical Director for the Oncology Nurse Navigator Program.



Detailed Dashboards allow for tracking providers by credentialing status, specialty, and availability.




Provider Records include clinic associations, program participation, services provided and specialties.




Provider Availability is part of Silverline’s Scheduling accelerator for contact center and community.




Credentialing record tracks the status of credentialing and allows engagement of physician liaisons.




Facility records include provider relationships, scheduling criteria, and system relationship tracking.


Thank you!

Download our eBook:Provider Roadmap

for Success

Check out our Healthcare Blogs!

Visit our Website:www.silverlinecrm.com

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