Set Up Provider Enrollment and Network Management

Help payers and provider groups to efficiently manage provider applications and enrollment, construct effective provider networks, and retain top healthcare talent using our Omnistudio-based workflows. Set up Provider Network Management to give your users a one-stop solution for provider registration, nomination, recruitment, credentialing, and verification and help members promptly find care that fits their needs.

Available in: Lightning Experience

Available in: Enterprise and Unlimited Editions with Health Cloud

Set Up Licenses and Permissions for Provider Network Management
To use Provider Network Management, set up the required licenses and permissions.
Verify Prerequisites for Setting up Provider Network Management
To use Provider Network Management, complete these prerequisites.
Configure OmniStudio Settings for Provider Network Management
To seamlessly run Provider Network Management OmniScripts in Health Cloud, disable the Managed Package Runtime setting.
Create User Roles for Admin and Standard Users
Create user roles for admin and standard users and associate users to their respective roles. Users associated with the roles can complete the recruitment process effectively.
Create the Carrier Record Type for Account
Help your credentialing specialists handle the provider credentialing and verification processes by setting up the Carrier record type for the Account object and creating the required account records. Providers select these carrier (insurance company) records when they fill in their Professional Liability Coverage information during the credentialing process.
Assign the Carrier Record Type for Accounts to User Profiles
Help your users handle the provider credentialing and verification process by assigning the Carrier record type you created for the Account object to the required user profiles. This setup makes the record type available to all users with those profiles and helps them handle the Professional Liability Coverage information during the credentialing and verification process flows.
Create the Provider Record Type for Contract
At the end of the provider verification process, Salesforce creates contracts of Provider record type. It’s important that you set up the Provider record type for the Contract object to help your credentialing specialists complete the provider verification process seamlessly.
Assign Languages to the Person Account Record Type
Help your credentialing specialists handle the provider enrollment process without any issues by setting up primary and secondary languages for the Person Account record type.
Set Up an Experience Cloud Site for Provider Network Management
Build an Experience site for your providers to use a configurable flow powered by OmniStudio to register themselves with a payer’s network, nominate a peer provider, create referrals, or perform the credentialing process.
Set Up DocuSign Integration for Provider Network Management
Help your credentialing specialists easily generate the credentialing application form for their providers by setting up DocuSign integration for Provider Network Management. Providers can then sign the credentialing application form and give their consent to join the payer’s network.
Enable Sharing Settings for Provider Network Management
Enable sharing settings for objects so that your site users (new or recruited providers) can access records that recruitment specialists create during the recruitment process. Specify the rule criteria for sharing records and select the users with whom the data must be shared.
Configure Field Level Security for Provider Network Management
Enable Field Level Security on a profile-by-profile basis to restrict your users from viewing or editing specific fields. Give appropriate access permissions on standard and custom fields for the Network Express Community User and System Administrator profiles to help your users handle the provider enrollment process without issues.
Configure Remote Site Settings for Provider Network Management
Before your Salesforce org interacts with an external site, you must register the site in the Remote Site Settings page, or else the interaction fails. For Provider Network Management, register the NPI registry site and your DocuSign account site.
Set Up the Lead Record Page Layout for Provider Recruitment Process
Add the OmniScript for provider recruitment to the Lead record page so that your recruitment specialist can complete the recruitment process for registered or nominated providers.
Set Up the Person Account Record Page Layout for Provider Verification Process
Add related lists and the OmniScript for primary source verification to the Person Account record page layout so that your credentialing specialists can complete the verification process for their providers.

Health Cloud Administration

See Also