The Future Healthcare Today Podcast12 Des 2023

Ep 15 - Joining a Provider Network: Predictable, Visible, and Designed to Benefit Everyone

In a previous episode of the Future Healthcare Today Podcast, the editorial team heard from three healthcare network solutions experts at Zelis about how payers can create and maintain a robust collection of providers and the benefits that this brings. However, the relationship is a two-way street, as there are many tangible benefits to joining a provider network that accrue to the provider as well.

One of the most important benefits according to Tammie Skiles, Senior Vice President for Network Solutions at Zelis, is the predictability that comes from being part of a network. “Contracts are negotiated so everyone understands the agreement for services, fees, and schedule rates,” she told Future Healthcare Today. Additionally, there is an expectation that being in-network creates an easier path for patients to find a provider that will meet their needs.

“As a provider, you really are looking for a partner who can steer members to your office, or chair as we say in dental,” Kim Sharbatz, Senior Director for Strategic Network Partnerships said. Ideally, an effective provider network ensures providers have few, if any, gaps in their schedule.

Finally, as Robin Marino, Director for the Zelis Dental Network said, providers can also get further benefits through access to major carriers and TPAs. “It’s a big reason providers approach [companies like Zelis], you sign one contract and gain an opportunity to reach many members and can save time with compliance, network needs, and credentialing.”

As providers navigate the next generation of healthcare needs and trends changing the industry, being a part of an established provider network affords the ability to thrive.

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