Oscar Health + Certify
In 2022 Oscar Health, a national Health Plan serving 1.5M members, and Certify, the industry's premier provider data intelligence platform partnered to improve provider network operations at Oscar Health. The initial goals of the partnership were to improve the provider experience, decrease administrative costs, and improve provider data quality. These goals were going to be focused on provider monitoring, credentialing, and credentialing efforts as Oscar Health scaled their provider network nationally. Both organizations are extremely proud to say we've seen tremendous results including significant decreases in cost, more efficient operations, and improved provider satisfaction.
Share this article:
RELATED ARTICLES
- BlogWe’ve all heard the headlines: AI is taking over because it’s better, faster, and cheaper than the human alternative. This may be true in some industries, but that’s not the case when it comes to healthcare. In fact, recent data paints a very different picture.
- BlogSimon Maas is originally from Vancouver, BC where he grew up in a family of physicians. He earned his BA from Harvard where he was also on the varsity lightweight rowing team. He’s been the COO at Certify since October 2023 and lives with his family in Los Angeles.
- BlogFor health plans, maintaining accurate provider information is essential for regulatory compliance and claims processing. Delegated credentialing serves as a valuable strategy to offload administrative tasks, but it also creates new challenges. While delegated entities manage their provider rosters by verifying and monitoring providers, a significant issue arises when these entities return rosters in incomplete, inconsistent, or incompatible formats. This creates a substantial burden for health plan teams who must manually clean, validate, and ingest this data into their specific data schema and format that drives downstream business processes.