Oscar Health + Certify
In 2022, Oscar Health, a national Health Plan serving 1.5M members, and CertifyOS, 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
- BlogProvider Data Management (PDM) was once a small-scale administrative function but has now become a foundational part of healthcare operations, influencing everything from claims processing and member experience to compliance, quality scores, and patient outcomes. As site provider networks expand, affiliations multiply and care delivery grows more complex, the systems responsible for managing provider data have struggled to keep pace.
- BlogFor payers, every hiccup in provider data management (PDM) aggravates an already stressed system. Errors in provider directories or credentialing data lead to provider and member abrasion and denied claims. Operational breakdowns increase administrative costs and workforce attrition. And evolving regulatory requirements, from NCQA standards to the No Surprises Act and Transparency in Coverage rules, raise the stakes even higher.