Wellcare Health Plans to Streamline Credentialing, Enrollment, and Other Processes with Medversant Technologies, LLC

LOS ANGELES & TAMPA, Fla.--(BUSINESS WIRE)-- WellCare Health Plans, Inc. (Wellcare), the nation’s largest publicly traded health plan focusing on Medicaid and Medicare, has outsourced credentials collection and verification to Medversant Technologies, LLC (Medversant), and will utilize a range of technology solutions to integrate provider data management. This is the first time the company has outsourced this key area which will streamline the credentialing process for more than 40,000 providers in 12 states.

Health plans must collect and verify provider information in order to admit healthcare professionals into their network to provide coverage to their members, in accordance with both state and federal law. Traditionally, provider data is managed in both the network relations and credentialing divisions of larger health plans. Recently, there has been an increased focus on the overall process of “provider data management” as a key to achieving efficiency. Moreover, provider data has become a crucial component of effective health plan administration.

According to Ted Schwab of Schwab Healthcare Strategies, a healthcare industry consultant, “The process of provider data management is cumbersome and costly. Inefficient provider data management results in excess labor, inaccurate provider data, claims fraud and patient safety issues.” In order to meet these industry needs, Medversant Technologies, LLC has developed a plug-and-play, end-to-end, and fully integrated provider data management solution. Matthew Haddad, CEO of Medversant states, “We carefully analyzed the WellCare process and determined that there were significant efficiencies to be achieved through adoption of our integrated provider data management solution.”

Developed over a ten year period, Medversant offers a stable, state of the art platform which addresses provider data collection, accuracy, verification and integration. Medversant’s integrated approach to provider data brings efficiency to processes such as credentialing, enrollment, provider relations, claims payment and member relations. Ellen Gallagher, Sr. Director of Corporate Provider Services at WellCare states, “The Medversant team quickly assessed our situation and recommended a combination of technologies and services that gave us a tangible and meaningful ROI.” WellCare will be utilizing a range of services and technologies including:

• ProviderSource™, a provider data collection solution which features a first of its kind, interactive online communications portal
• Encompass™, a comprehensive credentials management platform
• OneSource, a verification services outsourcing solution featuring Medversant’s patented AutoVerifi™ (U.S. Patent No. 7,529,682) technology

Wellcare’s decision to outsource to Medversant is a major step and a first for the company. According to Gallagher, “We made our decision very carefully, considering its importance. We had to be sure that this was a stable platform to support our extensive provider network.” WellCare ‘s provider network of over 40,000 covers 12 states including Florida, Illinois, Georgia, New York, Texas, etc. According to Dr. Qin Ye, Senior VP of Information Technology and Operations for Medversant, “Our platform is uniquely suited to multi-state operations such as WellCare. Stability and scaling of technology is often overlooked in outsource decisions and this is where Medversant brings significant assets to the table. As more and more health plans seek solutions to streamline administrative costs in the wake of healthcare reform initiatives, Medversant’s integrated provider data management offering couldn’t be more timely.”

About Medversant

Headquartered in Los Angeles, California, Medversant Technologies, LLC, provides rapidly deployed, end-to-end and fully integrated Web-based provider data management solutions. Organizations can outsource processes and use Medversant’s state-of-the-art shared platform technology without incurring license fees, maintenance fees or software-as-service subscription fees. Medversant’s solutions directly address provider data collection, credentials verification, enrollment, accuracy of provider data, contracting, systems integration and can reduce fraud and waste. Medversant is the creator and exclusive provider of AutoVerifi™ (U.S. Patent 7,529,682), the process and method for continuous electronic verification of provider credentials. Medversant is certified by NCQA and accredited by URAC as a national Credentials Verification Organization. Contact 213.291.6139 or visit www.medversant.com.

About WellCare

WellCare Health Plans, Inc. provides managed care services exclusively for government-sponsored health care programs, focusing on Medicaid and Medicare. Headquartered in Tampa, Florida, WellCare offers a variety of health plans for families, children, and the aged, blind and disabled, as well as prescription drug plans. The Company served approximately 2.2 million members as of March 31, 2010. WellCare is committed to sound principles of corporate governance. In furtherance of this commitment, WellCare has adopted and operates pursuant to the principles set forth in its Code of Conduct and Business Ethics and Compliance Program, iCare. Contact 866.530.9491 or visit www.wellcare.com.

CPR Strategic Marketing CommunicationsAlyson Kuritz, 201-641-1911 x51
[email protected]

Source: Medversant Technologies, LLC