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Silverline Healthcare: Provider Network ManagementMatt Gretczko,VP, Head of Healthcarematt.gretczko@silverlinecrm.comJim Rogers, RN, BSNDirector, Healthcare Practicejim.rogers@silverlinecrm.com
SILVERLINE HEALTHCARE AND LIFE SCIENCESWho is Silverline: Fast Facts350 1,100 ResourcesSalesforce ProjectsLocations Headquartered in NYC Offices in Chicago, Orlando, Omaha,Minneapolis and Bangalore (India) Resources around the globe175400 4.8/52009Assets & AcceleratorsSalesforce CertificationsCustomer SatisfactionFoundedAccoladesSilverline Key Informationo Sole platform focus is Salesforceo Dedicated Healthcare Practice - Advisory, Presales,Delivery, Supporto 2019 Salesforce HLS Consulting Partner of the Yearo 2018 Salesforce Partner Innovation Awardo Dedicated focus on Health Cloud; ContinuedAlignment to RoadmapExpertiseHealthcare Provider Payer Biotech/Life Sciences Medical DeviceFinancial ServicesPlatformSalesforce Certificationso Technical, Functional, Operational, and ClinicalHealthcare Expertiseo Glassdoor 2018/2019 Top 3 Nationally RecognizedBest Place to Workpilot partner
SILVERLINE HEALTHCARE AND LIFE SCIENCESProvider Roadmap: Enabling Patient Engagement SuccessPROVIDERRELATIONSHIPMANAGEMENTCONSUMER &PATIENTENGAGEMENTAMBULATORY CARECOORDINATIONTRANSITIONSIN CARESPECIALTY CARECOORDINATIONBuild Provider &Clinic/Facility ProfilesPatient Access CenterTrack and ManageRisk & CostManage AcuteDischarges to PCPPatient Community forOnboardingManage ACO &Integrated NetworksReferral NavigationCoordinate Care viaCare PlansTransition CareManagement (TCM)Oncology NavigationProgramsCreate Tiered SystemRelationshipsConcierge CareModelsComplex CareManagement (CCM)ProactiveReadmissionPreventionJoint ReplacementProgramsProvider ProgramParticipationTargeted PatientEducationMedicare InnovationProgram ManagementStep-down CareManagementBariatric SurgeryProgramsTrack Onboarding &CredentialingSymptom-Based 24/7Nurse TriageCare GapsManagement - HEDISDischargeAssessment & TriageInternational/TravelCare ModelsProvider & Care TeamEngagementPatient EngagementJourneysAmbulatory CareJourneysPost-Acute PatientJourneysCare ManagementPatient Journeys Confidential - Silverline - Do Not Distribute
SILVERLINE HEALTHCARE AND LIFE SCIENCESOur Patient Engagement POVThe foundation for patient engagement begins with an agentworkflow-centric access or contact center and a 360 view of the patient.Maximizing member engagement requires omni-channel communication,and the introduction of patient journeys.Access/Contact CenterCare Management Agent/Role-Driven Patient 360 Longitudinal Care Timeline View Dynamic Call Routing, Call Scripting,Task Management Data Analytics-Driven Risk ScoringPatient Journeys Align communication to “best” or“preferred” channel Consumer to Patient Conversion Omni-Channel Engagement Real-time Care Gap Identification andMitigation Scheduling Management Chronic Condition Care Management Referral Management Dynamic Care Plan Templates Condition-Specific KnowledgeEnablement Next Best Offer/Action Cost Avoidance Strategies Context-Specific Knowledge Social Determinants Integration Provider/Facility Search Manage Care Transitions RSVP - Campaign/Event Registration Service Line Care ManagementPathways CONFIDENTIAL - SILVERLINE - DO NOT DISTRIBUTE Patient Loyalty and Satisfaction Patient-Centric Wellness Journeys Billing/Claims Status Updates Care Pathway Engagement Mobile and Community Engagement
Silverline HealthcareProvider Network Management CONFIDENTIAL - SILVERLINE - DO NOT DISTRIBUTE
SILVERLINE HEALTHCARE AND LIFE SCIENCESProvider Network ManagementCreating and defining your provider network is a critical first step in managing patientsand navigating them within your healthcare system. Whether you are a clinicallyintegrated network (CIN) or an accountable care organization (ACO) you must managereferrals from primary care to specialty care and services within your healthcare system.The successful result of this is two-fold: Create continuity of care for your patients to increase efficiency and effectively track quality Increase opportunities to retain downstream revenue within your networkThe key to defining your provider network in a manner that impacts your patient navigation is to buildand maintain provider and clinic profiles that go beyond the traditional credentialing data to include: Services provided in the clinic Procedures performed in the clinic and the outpatient setting Locations with directions, parking instruction, and public transportation routes Scheduling rules or restrictions at the provider, clinic or insurance level Up-to-date notifications on provider availability Confidential - Silverline - Do Not Distribute
SILVERLINE HEALTHCARE AND LIFE SCIENCESProvider Network ManagementIt is also important to track provider participation in your individual ACO’s, risk-basedprograms, and value-based programs. Some providers in your network may beemployed, while others may be members of your CIN/ACO or be on active staff with ahealthcare facility.Silverline’s Provider Network solutions typically include: Manage contract requirements, compliance, and milestones Create and manage the providers and clinics in tiers, (relationship between the provider and thehealthcare system) Safe harbor scripts to inform the consumer/patient of the relationship between the provider andthe healthcare systemOne unique approach to provider network management is to manage the onboarding process forproviders and clinics in Salesforce. Tracking the HR, IT, Telecom, Real Estate, Legal, Credentialing, and other processes Individual departments to collaborate and simplify communication Introducing the provider to the new network and the network to the new provider Change referral patterns and increase in-network utilization before their go-live date. Confidential - Silverline - Do Not Distribute
SILVERLINE HEALTHCARE AND LIFE SCIENCESProvider Network ManagementEngaging with providers in your network is critical to increasing quality and enhancing thepatient experience.Provider Relationship Managers, sometimes called Physician Liaisons, are valuable members of theprovider network but often lack the tools to effectively communicate and track their relationship withproviders or collaborate with others calling on providers or clinics.There are several options for creating and managing this communication network:1. Utilize standard Salesforce Health Cloud functionality to build and maintain provider and clinicprofiles including email templates, surveys, lead and opportunity management and mobile accessto records.2. Add Marketing Cloud to enhance communication via journeys for provider acquisition,onboarding and targeted communication.3. Create a Provider Community to share information directly with providers and clinics, facilitatedocument sharing, enable direct updates of profiles and access to the shared provider andservices directory. This can also support a referral management workflow. Confidential - Silverline - Do Not Distribute
SILVERLINE HEALTHCARE AND LIFE SCIENCESProvider Network ManagementAlignment to Health Cloud Provider Data Model is Critical Confidential - Silverline - Do Not Distribute
SILVERLINE HEALTHCARE AND LIFE SCIENCESProvider Network ManagementAlignment to Health Cloud Provider Data Model is Critical Confidential - Silverline - Do Not Distribute
SILVERLINE HEALTHCARE AND LIFE SCIENCESReferral Management DemoMaria Gonzalez is a 28 year old newly expectant mother who is married and lives in the city.Lauren Weiss is a primary carephysician with UnitedPhysicians Group. She participates in twoACO programs.Jennifer Bosworth is providerspecializing in Women’s HealthServices. She practices at twoclinics and provides 5different services.George Borgrave is a bariatricsurgeon with United Physicians. Her performs his surgeriesat the Silverline ASC.Alice Abrams is an oncologistwith Silverline Oncology. She is the Medical Directorfor the Oncology NurseNavigator Program.
SILVERLINE HEALTHCARE AND LIFE SCIENCESProvider Network ManagementDetailed Dashboards allow for tracking providers by credentialing status, specialty, and availability. Confidential - Silverline - Do Not Distribute
SILVERLINE HEALTHCARE AND LIFE SCIENCESProvider Network ManagementProvider Records include clinic associations, program participation, services provided and specialties. Confidential - Silverline - Do Not Distribute
SILVERLINE HEALTHCARE AND LIFE SCIENCESProvider Network ManagementProvider Records include clinic associations, program participation, services provided and specialties. Confidential - Silverline - Do Not Distribute
SILVERLINE HEALTHCARE AND LIFE SCIENCESProvider Network ManagementProvider Availability is part of Silverline’s Scheduling accelerator for contact center and community. Confidential - Silverline - Do Not Distribute
SILVERLINE HEALTHCARE AND LIFE SCIENCESProvider Network ManagementCredentialing record tracks the status of credentialing and allows engagement of physician liaisons. Confidential - Silverline - Do Not Distribute
SILVERLINE HEALTHCARE AND LIFE SCIENCESProvider Network ManagementFacility records include provider relationships, scheduling criteria, and system relationship tracking. Confidential - Silverline - Do Not Distribute
Download our eBook:Provider Roadmapfor SuccessCheck out ourHealthcare Blogs!Visit our Website:www.silverlinecrm.comThank you!
at the Silverline ASC. Alice Abrams is an oncologist with Silverline Oncology. She is the Medical Director for the Oncology Nurse Navigator Program. SILVERLINE HEALTHCARE AND LIFE SCIENCES Provider Network Management Detailed Dashboards allow for tracking providers by credentialing status, specialty, and availability.
