Provider Network Management

Optimize end-to-end provider network management for Payors from recruiting and contracting to credentialing, recredentialing, and compliance with NCQA standards

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Recruitment
Recruit providers using geospatial tools integrated to invite and onboard new providers
Simplified Contracting
Manage contracts and renewals across multi-tiered networks while ensuring providerΩ compliance with state and federal regulations
AI Powered Credentialing & Recredentialing
Automate credentialing and recredentialing using AI agents to verify primary sources and continuously monitor sanctions and licenses 

Reduce administrative costs associated with managing and credentialing your provider network

50%
cost reduction in managing your network
80%
time reduction in credentialing and onboarding
Self-Service Provider Portal

Enable provider self-service through a modern portal that accelerates data intake and reduces administrative workload

CAQH
API

Ingest data via our CAQH API to improve timeliness and completeness of provider profiles

Workflow Automation & Configurable Queues

Automate workflows and routing with configurable queues, templated documents, and centralized case tracking

Reporting & Compliance

Ensure compliance with real-time reporting for directory verification, roster management, and credentialing status

Trusted by clients

“LightSpun was able to seamlessly integrate their platform with our existing systems and was able to deploy the entire platform within months due to the teams in-depth domain knowledge in technology, AI and dental”
Insurance Payer
VP, Information Technology
“Using LightSpun’s Contact Center Automation module, we expect to save $2M annually in call center operations, achieving a 64% cost savings.”
Large BCBS Plan
Director of Operations
“Our very manual, time-consuming and error-prone processes needed the injection of technology designed by those who have walked more than a mile in our shoes. We have been able to reduce 50% of FTEs!”
Blue Cross Blue Shield
Dental Director
“Using LightSpun’s Claim Intake Automation module, we will reduce manual intervention on paper claims by 95%.”
Insurance Payor
President
“Our claims administration cost was reduced by 50% thanks to LightSpun’s Claims Administration & Adjudication Platform.”
Insurance Payor
CEO
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Unlock your organization's full potential

Partner with Lightspun to make transformational changes to your organization. Our unified platform helps our customers achieve lasting results through intelligent automation, reduced processing time, and enhanced provider network management.

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