​​In March we sent a brief survey to take the pulse of our providers and networks regarding our platform transformation. We appreciate everyone who took the time to share their experience. Your comments provided valuable feedback as we work to improve your experience. 

We heard you

We have made certain technical improvements to address issues identified from survey feedback:

• The credentialing process is now handled internally and has been modernized. Once we receive completed documentation, processing generally takes less than 30 days, aligning with industry standards.
• We made changes to back-end matching logic for taxonomy codes, which will continuously improve the overall claim adjudication process.
• We are taking actions to simplify the prior authorization process. We are working to standardize provider submissions for electronic prior authorization and further reduce the use of prior authorization. The aim is to make the process more transparent with clear and personalized communications on what is needed to support approval, next steps, and available appeal processes. 

Resuming standard operations

During our transition, certain temporary processes were implemented that may have caused some delays. We are now resuming our standard business operations.

For example, claims for migrated members underwent comprehensive quality assurance checks following their initial transition to the new platform; this may have caused payment delays. Although this process enabled us to identify and resolve issues prior to payment release — reducing the need for claim reprocessing — we recognize it may have caused some frustration. We have now returned to our standard procedures for claims reviews.

As we move forward, we are diligently addressing the significant number of claim investigations. Additionally, we have equipped our Provider Customer Service representatives with enhanced training and resources to more comprehensively address the inquiries raised.

Looking ahead

We migrated our final group customers to our new platform on July 1. We are now focused on optimizing this new technology for greater efficiency and innovation. We truly appreciate your continued feedback as we work through these enhancements.  

Your insights have been invaluable in guiding our efforts. Now that our migration is nearly complete, we are committed to ensuring a better overall experience for you and our members. 

Thank you for your patience and support throughout the transition.

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To stay informed, we encourage you to review the resources available on our dedicated Platform Transition page.

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