Thought Leadership

New Perspectives To Improve the Credentialing Industry

Cooper University Health Care

Cooper University Health Care partners with Newport Credentialing Solutions and receives 400% ROI by implementing cloud based analytics and IT enabled credentialing services

The Problem: Lost revenue due to lack of centralization and effective credentialing software

Like most rapidly growing healthcare systems, Cooper University Health Care (Cooper) struggled with their provider enrollment. Due to aggressive provider on-boarding and system-wide growth, staff were overwhelmed with the high volume of new providers who were coming on board. With inadequate provider enrollment software, and a staff struggling to stay on top of new provider enrollment, as well as existing provider maintenance, Cooper’s provider enrollment edits were growing at an alarming rate causing increased write offs and lost revenue. Clearly, something needed to change.

Cooper partnered with Newport Credentialing Solutions (Newport) to proactively manage their credentialing needs. Newport provides cloud based software and IT enabled credentialing services to some of the largest health systems and academic medical centers in the country. Newport’s cloud based software and IT enabled services provide a highly flexible and revenue centric suite of solutions to help clients “Take Control” over their provider credentialing.

The Solution:Cloud based reporting software and IT enabled credentialing services to improve
revenue and accountability

After meeting with the Cooper team to understand their credentialing challenges, Newport implemented their IT enabled credentialing services. Because of Newport’s in-depth experience working with large health systems and teaching hospitals, Newport was able to immediately offer highly differentiated value through their centralized, cloud based software and on-site account management. “Newport immediately partnered with our revenue cycle and medical staff teams to identify un-enrolled providers and revenue improvement opportunities,” said Charles Reitano, VP of Revenue Cycle for Cooper. “The combination of Newport’s highly experienced on-site account managers and centralized IT enabled services quickly triaged our enrollment department and set out to implement system wide improvements. Newport served as a true partner in helping us quickly and efficiently reduce our credentialing edits and generate incremental revenue for our organization” said Reitano.

Newport made the transition for Cooper seamless by conducting a comprehensive, onsite data collection process. Once Newport collected all of Cooper’s data, Newport quickly built provider specific profiles in their cloud based system and began a comprehensive par/non-par analysis. “The par/non-par analysis is critical to any engagement because it establishes an enrollment baseline from which all other activities occur,” said Kenny Bergman, COO of Newport Credentialing Solutions. “Often, clients don’t have the bandwidth to conduct this revenue critical analysis, so Newport conducts an exhaustive par/non-par analysis as part of every engagement.

By utilizing cloud based technology, Newport is able to ensure that every provider is enrolled at every location and therefore are not losing system wide revenue due to enrollment lapses” said Bergman.

After completing the par/non-par analysis, Newport worked closely with Cooper’s revenue cycle and medical staff services offices to target providers with high credentialing related edits and denials. “Newport’s ability to work and adjudicate our credentialing related edits played a significant role in the rapid reduction in overall edits and write offs” said Francine Bargeron, Director of Professional Fee Billing. “The Cooper and Newport teams worked seamlessly together to identify providers who were not enrolled, enroll those providers, and adjudicate all outstanding edits and denials.” Further, Newport’s cloud based reporting software, CAREreport, provided the in-depth clarity that we needed to further improve the overall process.”

Outcomes:Significantly reduced credentialing edits driving increased revenue

From the start of the engagement, Newport exceeded Cooper’s expectations. By partnering with Cooper’s revenue cycle and medical staff office teams, Newport was able to reduce Coopers credentialing related edits by 68% in the first 12 months and by 90% in the first 24 months. The 98% improvement in credentialing related edits translated in $1.5M in incremental revenue to Cooper’s bottom line. “Cooper’s partnership with Newport has provided tremendous financial benefit to Cooper. Their use of cloud based reporting and analytics, deep provider enrollment expertise, and extensive payer contacts has helped our provider enrollment department evolve into an integral part of the revenue cycle and further enhance our highly performing organization” said Reitano.

“Newport’s mission is to provide our clients with industry defining, revenue centric, cloud based and IT enabled services which help them “Take Control” over their credentialing life cycle. Everything that Newport does is laser focused on helping our clients improve performance in a rapidly evolving healthcare environment,” says Kenny Bergman, COO of Newport.

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