Provider Screening Automation for Audit Compliance

This document is a case study detailing the implementation of Gainwell Provider+™ by the Department of Vermont Health Access (DVHA) to achieve 100% compliance with the state's 2024 audit requirements. The case study outlines the transition from a paper-based to an online enrollment process, focusing on automating provider screening to address audit findings related to lapsed provider licenses. Key results include automated communications with providers, enhanced coordination with state leaders, and a significant reduction in manual interventions, which shortened the enrollment screening process from hours to minutes. The document describes the essential components of the automated screening service, including weekly checks for license updates, configurable grace periods, and automatic notifications for providers. It also highlights the operational efficiencies gained through automation, such as improved enrollment efficiency and proactive provider communication, ultimately ensuring regulatory compliance and enhancing the overall provider experience.