THE PROBLEM
Chronic Difficulties for EDI Enrollment Management
Over the course of a year’s time an EDI enrollment department will process thousands of new EDI enrollments. These new enrollments will produce tens of thousands of separate payer EDI agreements, telephone calls, and mailings.
The enrollment process is the most labor-intensive requirement for an EDI transaction vendor. Tens of thousands of separate but related events must be tracked, recorded and acted upon in order to produce the desired outcome: revenue generated by processing EDI transactions. A vendor may experience some or all of the chronic problems faced by EDI enrollment managers:
- A complex manual EDI enrollment process
- Individual enrollment process by provider/location/payer
- Varied approval times by payer
- Unavailability of enrollment specialist (illness, vacation, leaves)
- Inability for all parties to view status of the enrollment process by payer
- Lengthy tracking process (60-90 plus days)
- Lack of formalized methods to handle process expectations and errors
- Inability to offer self-service enrollment processing to customers
- Lack of effective tools for tracking thousands of separate forms
- Step-by-step enrollment workflow not automated by software