Sutherland’s Shared Multi-Payer Credentialing Solution
Traditional credentialing is broken. According to a recent Sutherland–AHIP webinar survey, 50% of healthcare payers agree that credentialing is redundant, time-consuming, costly, and frustrating for both health plans and providers. So, what if there were a smarter way to eliminate the stress, reduce costs, and accelerate provider onboarding? Introducing: Sutherland’s Shared Multi-Payer Credentialing Solution Built ...
Reinventing Credentialing and Monitoring Compliance with Shared Models & Agentic AI
Speakers Experts from Sutherland, a leader in Payer Credentialing Services and Multi-Payer Credentialing Services, alongside Everest Group analysts, will share insights, trends, and practical takeaways.
Leveraging Automation and AI to Transform Healthcare Payer Operations
Healthcare tends to lag behind other verticals when it comes to digital transformation, but the gap is particularly pronounced when comparing payers to organizations in other information-intensive industries such as banking and general insurance. The need to catch up has never been greater, as healthcare costs continue to rise faster than government reimbursement rates. If ...
Sutherland’s Payer Credentialing Solutions
In an era of rising regulatory complexity and growing provider networks, payers need a smarter, faster, and more scalable way to credential to avoid any delays. Sutherland’s Payer Credentialing solution combines advanced automation, data intelligence, and deep healthcare expertise to transform every step of the credentialing process. Powered by our SmartCred® platform and decades of credentialing experience, we help payers reduce ...
Year One Reflections: Key Lessons from CMS Secret Shopper Surveys for Health Plans
The launch of CMS’s Secret Shopper Survey mandate in January 2025 marked a significant shift for Qualified Health Plan (QHP) issuers. For the first time on a broad scale, plans were required to prove timely access to care through independent appointment-availability surveys, with strict thresholds: 15 business days for primary care and 10 for behavioral ...
Beyond the Hype: Governing AI Responsibly in Healthcare
Originally published on healthcareittoday.com Imagine this: before a patient walks into the exam room, an AI chatbot has already answered their insurance questions and secured pre-authorizations. During the visit, real-time notetaking tools quietly capture every detail, freeing the provider to focus fully on care. By checkout, an AI system has assigned accurate billing codes and scheduled ...
6 Ways Generative AI Can Help Healthcare Payer CTOs Address Operational Challenges
Key Points The healthcare payer industry today is at a critical inflection point. Rising member expectations, regulatory complexities, care quality demands, and cost pressures are converging to challenge traditional operational models. From product design and member engagement to claims adjudication and compliance reporting, inefficiencies are pervasive across the payer value chain. While conventional digital solutions ...
Sutherland’s Healthcare Member Services for Payers
Sutherland’s Customer Experience Management (CXM) for Member Services empowers health plans to deliver personalized, high-quality care while improving operational efficiency and lowering cost-to-serve. With over 35 years of expertise, we help payers, including national and regional health plans, simplify interactions, reduce friction, and unlock operational agility to build lasting member trust. Our healthcare member engagement ...
Beyond the Algorithm: Building a Compassionate Revenue Cycle Management in the Age of AI
In today’s healthcare landscape, striking a balance between operational efficiency and patient empathy has never been more important. Revenue Cycle Management (RCM) sits at the heart of this healthcare provider challenge. While Artificial Intelligence (AI) is transforming how providers manage financial processes, there are areas where human understanding and emotional intelligence remain irreplaceable. The future ...