Streamline Your Credentialing Process

A configuration of Provider1™ platform for fast, accurate, and compliant provider credentialing
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Simplify Healthcare is positioned in the Leaders Category in the 2023 IDC MarketScape for U.S. health plan product/plan benefit configuration solutions.

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Transform your end-to-end provider credentialing journey

Master your credentialing process and guarantee timeliness and compliance with our next generation provider credentialing solution

Fast, validated applications

  • Multiple channels: Accept applications through various avenues with upfront validation for accuracy.
  • Embedded portlets: Seamlessly integrate credentialing into existing portals.
  • Empower providers: Providers can submit, upload, and track applications effortlessly.

Automated AI verification

  • AI-driven: Eliminate manual tasks with AI-powered primary source verification.
  • Direct integrations: Connect instantly with sources like CAQH and NPDB.
  • User-friendly management: Easily update and audit PSV sources.

Compliant workflows

  • Consistent processes: Configurable workflows ensure compliance and consistency.
  • Streamlined approvals: Expedite approvals with routine and electronic committee capabilities.
  • Comprehensive docs: Automatically generate and store approval letters and correspondence.

Continuous compliance

  • Stay compliant: Continuous monitoring and auto-updates for regulatory compliance.
  • Proactive alerts: Automated notifications for expiring credentials and sanctions.
  • Insightful analytics: Critical insights with provider analytics via PowerBI.

Fully integrated in Provider1™ suite

  • Shared data model: Data structures allow seamless integration with other Provider1™ modules.
  • Common platform: All Provider1™ modules are built on the same platform ensuring consistency and integration where needed.
  • Claims integration: Along with the rest of Provider1™, Credentialing attributes can be pushed to Claims systems seamlessly.

Power your connected provider journey with integrations

Extend the capabilities of Provider1™.Credentialing with a host of integrations to achieve end-to-end lifecycle management of your provider networks.
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.IntegrationHub

Use API and events to communicate data in a model that is easily consumable by target systems

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.DataServices

Enable OOTB and custom reporting, ad-hoc querying, analytics layer (e.g., Power BI), and file extracts

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.SuperUser.Studios

Empower superusers to maintain design, rules, and workflow configurations while also establishing governance

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.SelfServe

Enable Providers to load roster files, update facility, and location information, redline and sign contracts, and more

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.IntelliMatch

Enable multiple source inputs into Provider1™.PDM governed by rules at an attribute level

.AI

Leverage the power of Generative AI in features such as provider credentialing, smart ingestion of provider rosters (in any and all formats) into the provider database, on-demand provider analytics, and contract clause recommendations during renewals and negotiations

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.PDM

Integrate seamlessly with .PDM to enable end-to-end Provider Data Management

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.Contract

Integrate seamlessly with .Contract to enable end-to-end Provider contract management

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Service1™

Deliver accurate and complete answers to members, providers, employer groups, and brokers/agents for benefit inquiries

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Claims1™

Enable automated claims configuration, code set level configuration of benefits, and testing to support claims adjudication

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Experience1™

Automate dynamic content generation and stream accurate, compliant, and consistent benefits data across the enterprise

Simplify Healthcare is positioned in the Leaders Category in the 2023 IDC MarketScape for U.S. health plan product/plan benefit configuration solutions.