Reimagine Traditional Credentialing with a Proven Shared Service Model
Traditional credentialing is a redundant, costly, and frustrating process for both health plans and providers. Providers face manual application handling, repetitive requests from multiple payers with varying recredentialing cycles, and duplicate submissions to multiple plans—leading to dissatisfaction, delayed network participation, and slower access to care.
Sutherland’s MultiPayer Credentialing Solution reimagines this process with a shared service model across participating payers, including health plans, Medicaid, and Medicare. By consolidating outreach and sharing of credentialing administrative activities and costs, the model reduces provider abrasion driven by fewer touchpoints, while preserving each plan’s independent admission decisions.
As an NCQA-certified and URAC-accredited CVO conducting 1M+ primary source verifications annually, Sutherland helps payers cut credentialing time and costs, improve compliance with state and federal mandates, and enhance overall provider and member experiences.
Outcomes Delivered
Faster credentialing turnaround time
Reductions in Payer credentialing costs
More connects with Providers
Provider abrasion reduction
Reduction in phone call fatigue
Why This Model Beats Traditional Credentialing
| Dimensions | Traditional Credentialing (Plan-by-Plan) | Sutherland’s Multi-Payer Credentialing Model |
|---|---|---|
| Outreach to Providers | Multiple, redundant touches by each plan | One coordinated outreach with common cadence |
| Recredentialing Dates | Different cycles and standards per plan | Common, NCQA-compliant schedule for overlapping providers |
| PSV Execution & Cost | Each plan pays full PSV and 3rd-party fees | Shared PSV and pass-through cost efficiencies |
| Operational Effort | Duplicative workflows and IT infrastructure | Centralized processing with SmartCred™ platoform-led automation |
| Provider Experience | High abrasion and administrative burden | Reduced fatigue and faster approvals |
| Speed & Throughput | Variable, committee bottlenecks | Proven 20% faster cycle overall |
| Compliance & Quality | Inconsistent controls | Standardized QC with risk sorting and dashboards |
How the Multi-Payer Model Works
Overlap Analysis & Shared Schedule
We analyze participating plans’ rosters to align overlapping providers and set a common, NCQA-compliant recredentialing calendar (standard models are available for non-overlapping populations).
Unified Provider Outreach
Automated Primary Source Verification (PSV)
Committee-ready Packets
Distribution, Reporting & Dashboards
Benefits
Reduced Administrative Costs
via shared PSV and consolidated outreach.
Enhanced Efficiency
with automated verification and exception handling
High Compliance Standards
aligned to NCQA requirements
Greater Transparency
through near real-time dashboards
Platforms
Automates credentialing to improve quality, consistency, and speed, using omnichannel outreach to reduce provider friction and accelerate turnaround.
Sutherland SmartCred®