Staff Readiness Services

Credentials Verification and Provider Enrollment

Credential Verification and Provider Enrollment saw an overall increase in volume from 2021 with 4194 completed credentialing files and 3,104 completed submissions and approvals.  Our Customer Service team completed 5055 service requests via phone and email, seeing a massive increase in volume overall. Our services continue to meet regulatory requirements while our team continues to work towards high-quality standards.

Provider Enrollment saw a significant growth in overall volume and customers as it continues to be a needed service for our partners in healthcare. The program grew more than double with 3,104 completed submissions and approvals.

Highlights from 2022:

• Selected by New Mexico Medical Board (NMMB) as part of special project to be the sole processor for initial application for providers applying for NMMB licensure for NMMB applicants.

• Grew our customer base with many new credentials verification customers across 6 different states.

• Began onsite consultation and training service to assist customers with streamlining the in-house portions of their provider onboarding, credentials verification process, and provider enrollment.

• Received endorsements from the Arizona Hospital and Healthcare Association and other North Carolina Hospital Association

• Began development of the conducted value stream mapping to help design Provider Enrollment internal software to further automate.

• Grew our customer base with  new provider enrollment customers across 4 states.

• Conducted several Provider Enrollment Audits to help customers identify potential enrollment gaps and possible gaps in contracting.

• Provided onsite review of an out of state partner to assist with streamlining their overall process in an effort to create efficiencies and to avoid gaps in the provider enrollment process which contributes maximizing overall reimbursement and patient access.

Risk Management

Workers’ Compensation Services

During 2022, the New Mexico Hospital Workers’ Compensation Group saw a decline in claims by 22% New Mexico mandated that any health care worker who contracted COVID while treating patients would be a covered claim under the presumption that COVID was contracted at work. This Order remained in effect during 2022. 

 Unemployment Compensation Services

In 2022, the Joint Unemployment Compensation Program saw a 32% decrease in claim frequency over 2021.   This frequency is substantially lower than last year and near pre COVID-19 levels. With the end of government assistance reimbursable employers were responsible for 100% of unemployment claims expense in 2022.

HealthXnet

HSC has endeavored to expand HealthXnet services into Arizona. Our software has been endorsed by the Arizona Hospital and Healthcare Association. Our software continues to be the one portal, one login solution for a growing number of subscribers making millions of eligibility and claims inquiries every year. The ease and efficiency of the HealthXnet tool allows front-line employees to quickly verify eligibility and benefits inquiries. This is a critical step toward obtaining accurate and detailed information for patients, which in turn can lead to higher patient satisfaction levels and fewer claims denials. We are excited to grow our HealthXnet service line providing this exceptional tool in other states.