MENOMONEE FALLS, Wisc. – April 5, 2018 – In keeping with its dedication to delivering technology-enabled solutions and professional services that drive operational excellence and reduce costs for healthcare payers, Scion Dental, a dental benefits management organization now under the unified SKYGEN brand, today announced its Credentialing Service has been awarded Credentialing and Recredentialing (CR) Accreditation by the National Committee for Quality Assurance (NCQA). The accreditation, which is valid through February 2020, applies to certifying or recertifying credentials for providers participating in commercial and government-sponsored health plans, including dental, vision, and medical lines of business.
“Our organization is laser-focused on helping our clients achieve operational excellence in every aspect of their business,” said John Schaak, chief operating officer of SKYGEN. “It is one of the keys to improving service to providers and members while reducing costs significantly. Earning NCQA accreditation is one more example of the lengths to which we go to achieve that goal.”
The Credentialing Service makes building and maintaining provider networks more cost-effective, convenient, and less of a burden for both payers and providers. Rather than having to submit the same information to each payer network they want to join, providers submit their credentials one time to the Credentialing Service. This “one and done” approach saves providers hours of redundant labor. Once they are in the system, providers can direct payers to the Credentialing Service any time they receive a request for credentialing information. When payers go to the Credentialing Service they can download the information they need on-demand in minutes, saving time and money normally spent on costly outreach. SKYGEN also offers primary source verification services and ongoing monitoring. The Credentialing Service is part of an entire suite of on-demand solutions that help healthcare payers transact critical business processes with their members and providers in real time, when and where they need it.
The NCQA CR accreditation is valuable to both government-sponsored and commercial payers. For government-sponsored programs, it decreases the amount of auditing payers must perform to ensure the quality level maintained by their credentialing partner meets individual state standards. Although commercial payers have less stringent regulations around credentialing, ensuring quality in critical processes is a business priority for them. With the NCQA accreditation, commercial payers can be confident their credentialing partner is following the highest standards and best practices.
Awarding of the accreditation follows the completion of a rigorous, six-month audit to determine how well the organization’s policies and procedures comply with NCQA’s standards. The audit takes a deep dive into factors such as whether the applying organization has a quality improvement infrastructure; the ability to protect the confidentiality and integrity of credentialing files; a designated committee to make recommendations regarding decisions about providers’ credentials; and the process to verify credentials. The Credentialing Service passed the test, ensuring payers who delegate provider credentialing to SKYGEN will attain the highest levels of quality throughout their provider networks.
“Achieving NCQA CR accreditation is tremendous validation of our approach to ensuring the quality of every aspect of the provider credentialing process,” said Michael Lessila, director of credentialing services at SKYGEN. “It demonstrates the commitment we have, both as an organization and as individuals, to helping our clients meet compliance requirements while operating more effectively and efficiently. We are proud to add NCQA CR accreditation as yet another proof point of the value of working with our organization.”
SKYGEN powers healthcare transformation forward through innovative, next-generation technology-enabled solutions and data analytics that inspire stakeholders to challenge the status quo and create better alignment to drive efficiency, reduce costs, and elevate experiences for all throughout the digital age. It helps payers of all sizes and across all lines of business become the most efficient health plans in the country through a portfolio that includes Benefits Administration, Enterprise Technology, On-Demand Solutions, and Professional Services. SKYGEN powers the nation’s largest healthcare insurers with clients operating in over 100 markets, serving 35 million member lives on its technology platform, and 10 million member lives through its outsourcing solutions.
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