Case Study: WPS Health Solutions

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WPS Health Solutions 

This chapter was originally published in Intelligent Adaptability

Nominated by Naviant, Inc. & Hyland, USA

WPS Health Solutions is a Medicare Administrative Contractor (MAC). As a MAC, one of the services WPS provides is to credential and enroll more than 100,000 physicians and medical facilities that would like to offer services to Medicare patients. The credentialing process for provider enrollment is a labor-intensive process of research and validation of the 300+ pieces of information that are submitted in a standard application an effort to ensure providers follow industry standards, and to detect and minimize potential fraud and waste in the Medicare system. In addition to case management functionality and the components, WPS leverages the full range of native built-in capabilities within its solution, including data and document management, electronic forms, workflow automation and process logic, and security controls.

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