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Health Plan Streamlines Provider Portal Access Management

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Project Case Study

The Challenge

A Community Health Plan needed to allow providers to see all claims they were party to without having to log in multiple times under different accounts. Though providers could self-register to this client’s portal, they also needed a secure way to access other claims that they were involved with.

Because their providers were organized into a deep structure of TINs, NPIs, Office IDs, and Vendor IDs, this client needed a way to efficiently manage provider levels of access without excessive manual intervention. With security and efficiency as their priorities, this client contacted HPS for a solution.

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Our Solution

HPS jumped into action by defining rules that would govern which provider login accounts should have access to which information. This resulted in development of multiple levels of provider portal access, ranging from a single physician, to an office manager accessing claims for multiple physicians, to a hospital system administrator accessing claims for multiple hospitals and facility locations.

HPS also created a streamlined process for our client to manage provider login accounts and their claims access. For example, if an office manager had access to claims for one TIN/NPI but needed access for the other physicians in the clinic, our client could do a quick search to assign the additional TINs/NPIs to that login account.

Lastly, HPS automatically updated provider login accounts with claims access for new facilities. For example, if a hospital system opened another location, provider accounts tied to that hospital could automatically access claims for the new location. This updated access in a rules-based way without our client’s manual intervention.

The Results

With the new structured, methodical approach, this client saved more than 500 hours’ worth of manual intervention for its provider login account management. This contributed to faster, more responsive provider service. Also, because of the scalable security rules, one provider account can have access to claims for thousands of physicians, without logging in multiple times or compromising security of patient data.

Why HPS was the Best Choice

Specializing in rules-based security restrictions, HPS tailored provider login account management to the client’s unique data structure, while maintaining security. All stages of solution design and programming were thoroughly tested to ensure the highest security and ease of use.

About HPS Provider Portal Access Levels

HPS offers up to 4 levels of provider access, ranging from an individual physician to a hospital system administrator. Provider access levels are custom-fitted to each client’s provider data structure and configured in a way that allows login accounts to automatically incorporate data from new TINs/NPIs they are party to. This solution gives clients more of a hands-free way to manage provider login accounts while maintaining patient data security.

HPS Client Success Story - Provider Account Management-20211015

Download this Case Study as a PDF