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Silverline Healthcare: Provider Network ManagementJim Rogers, RN, BSNDirector, Healthcare Practicejim.rogers@silverlinecrm.com
Matt Gretczko, VP, Head of Healthcare
matt.gretczko@silverlinecrm.com
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
SILVERLINE HEALTHCARE AND LIFE SCIENCES
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
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SILVERLINE HEALTHCARE AND LIFE SCIENCES
○ 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
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Our Patient Engagement POV
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Silverline Healthcare
Provider Network Management
SILVERLINE HEALTHCARE AND LIFE SCIENCES
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
Provider Network Management
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.
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SILVERLINE HEALTHCARE AND LIFE SCIENCES
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.
Provider Network Management
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.
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SILVERLINE HEALTHCARE AND LIFE SCIENCES
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.
Provider Network Management
Engaging with providers in your network is critical to increasing quality and enhancing the patient experience.
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SILVERLINE HEALTHCARE AND LIFE SCIENCES
Provider Network ManagementAlignment to Health Cloud Provider Data Model is Critical
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SILVERLINE HEALTHCARE AND LIFE SCIENCES
Provider Network ManagementAlignment to Health Cloud Provider Data Model is Critical
© Confidential - Silverline - Do Not Distribute
SILVERLINE HEALTHCARE AND LIFE SCIENCES
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.
SILVERLINE HEALTHCARE AND LIFE SCIENCES
Provider Network Management
Detailed Dashboards allow for tracking providers by credentialing status, specialty, and availability.
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SILVERLINE HEALTHCARE AND LIFE SCIENCES
Provider Network Management
Provider Records include clinic associations, program participation, services provided and specialties.
© Confidential - Silverline - Do Not Distribute
SILVERLINE HEALTHCARE AND LIFE SCIENCES
Provider Network Management
Provider Records include clinic associations, program participation, services provided and specialties.
© Confidential - Silverline - Do Not Distribute
SILVERLINE HEALTHCARE AND LIFE SCIENCES
Provider Network Management
Provider Availability is part of Silverline’s Scheduling accelerator for contact center and community.
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SILVERLINE HEALTHCARE AND LIFE SCIENCES
Provider Network Management
Credentialing record tracks the status of credentialing and allows engagement of physician liaisons.
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SILVERLINE HEALTHCARE AND LIFE SCIENCES
Provider Network Management
Facility records include provider relationships, scheduling criteria, and system relationship tracking.
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Thank you!
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for Success
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Visit our Website:www.silverlinecrm.com
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