Provider enrollment workflow
A six-part provider enrollment workflow that is easy to navigate. Access a human-centered, intuitive online portal that offers real-time responses and simplifies the entire enrollment process. Providers can complete an application in as little as 20 minutes.
Product features
Improved transparency
Get access to robust provider metrics through executive and operational dashboards, providing a comprehensive view of your provider network. With insights into location, type, and enrollment status, states can better understand geographical gaps and identify communities that may be underserved and in need of additional Medicaid provider coverage.
Flexible integration
Compatible with existing modules, legacy systems, and third-party vendors, you can manage all provider types, organizations and atypical providers with ease. With over 100 configurations that allow for automated enrollment decisions, customizable instructions and more, Optum supports easier implementation into your current environment.
Enhanced administration for agencies
Our self-service gateway and support system simplify administrative activities, enhancing user experience and reducing total cost of ownership. The intuitive design ensures that agency staff can easily manage and monitor provider participation in Medicaid programs.
Reduced enrollment time
Dynamic screen workflows, up-to-date application status, easy-to use self-service capabilities and embedded tips and training reduce redundancies and speed up the enrollment process.
Ongoing assistance
From licensure and automated verification to simplified maintenance, we provide continuous support to ensure providers can focus on delivering quality care.
Key benefits
Choose a partner with experience.
Uniquely suited to serve you
No other Medicaid Provider Management solution is built on the experience that Optum has in managing and operating provider networks.
Harness our deep resources
We manage more than $120 billion in net patient revenue for our partner hospitals and physicians' practices, and work with more than 90,000 aligned care delivery physicians across Optum Health.
A vast care network
Our network is built on more than 1,600 primary and specialty care clinics, 300 Optum Care Ambulatory Surgery Care Centers (including SCA), and approximately 2,470 home and community contracted skilled nursing home facilities.
Continuous modernization for enhanced user adoption
Our mobile-first solution ensures easy access and a user-friendly experience on all devices. We’re committed to continuous improvements with regular updates to meet the evolving needs of provider enrollment and management.
Choose Optum as your NASPO ValuePoint vendor
Streamline your procurement process and save time with NASPO ValuePoint. Optum is a CMS pre-approved ValuePoint solution provider for the MMIS Provider Services Module. We provide our core provider management capabilities through ValuePoint’s cooperative procurement process, along with additional options for full-service management and enhanced self-service.
We are here to support your agency every step of the way, ensuring you have the tools and support you need.
Related healthcare insights
White paper
By applying analytics solutions, states can create a comprehensive roadmap to better health equity.
Guide
Learn how identifying and addressing disparities in healthcare allows everyone to live their healthiest life.
Article
See success rates, risks and costs of the new Alzheimer’s treatments.