Getting you ready to win business
Writing compelling proposal responses
Winning and retaining new business
Successfully implementing your promises
Provider Network Services
Helping you build a compliant network
Contracting your provider network
Getting your team of providers credentialed
Managing your network
Compliance and Quality Services
Auditing your specialty network for billing compliance and quality services
Data extrapolation for CMS required rebilling
Clinical business audits and program development
Crestline Advisors Services
Crestline Advisors helps you to respond to RFPs and grants successfully. We collect, curate, and deliver market intelligence across business domains. Crestline Advisors uses business intelligence (BI) and internal and external evaluation data to determine the strengths, weaknesses, opportunities (SWOT), and risks of new business. This step facilitates the development of win themes and risk mitigation strategies.
The BI and SWOT analyses, win themes, and risk mitigation task serves as the foundation necessary for the RFP response. Using this knowledge and our specialized approach to data presentation, our Subject-Matter Expert writing team works with you to formulate a contractually compliant proposal that wins! Crestline Advisors’ approach results in an RFP response that is the framework for timely and effective implementation.
Crestline Advisors knows that the key to a health plan’s success is an effective delivery system. Our team of Provider Network Subject Matter Experts supports network analysis and network builds to meet contractually driven adequacy standards. Our experience extends to the development of specialty, medical, and tertiary networks along a continuum of contract types, from the easiest to the most complicated.
Recognizing all the pitfalls associated with provider data accuracy, our team assists with credentialing your network, building contractually defined databases to track status and timelines. Plus, if you need help training or managing your provider network, our experts know that a key to implementation success is your network’s ability to adapt to your business requirements timely.
Crestline Advisors understands the challenges health care providers and health plans face in maintaining regulatory and contract compliance. Our team of seasoned professionals assist clients by offering compliance-focused training to the Board of Directors which serves to prepare them to understand the regulatory environment and their roles in assuring an organizational commitment to compliance. We can also help clients to develop their compliance programs and plans, in accordance with Centers for Medicare and Medicaid Services guidelines.
We also offer a suite of compliance auditing services. Specifically, we offer both quality and fraud, waste, and abuse (FWA) auditing for medical, behavioral health, and specialty services, including long term services and supports. Crestline’s team can assist your organization to develop your own auditing protocols and tools to up-level your internal capabilities. Our expertise in auditing includes knowledge of statistical sampling techniques and overpayment estimation.
Crestline Advisors’ expertise extends our support of business development across types of healthcare organizations. In addition to business expansion through successful RFP and grant responses, we work with health plans and providers to increase revenues and market share by through expansion into new geographies, by adding new services, and through acquisition and merger. Initially, we conduct an organizational capacity review and an operational assessment. We look at potential opportunities, and analyze the competitive landscape. The next phase of the business development process is Strategic Planning. Our approach is simple and straight forward. Working with the leadership and Board of Directors, we look at the current business state and determine where you want to go in the future. We use goal-driven approaches tied to financial targets to develop a short-term plan that is easy to follow and actionable!
We also help providers to create new lines of business through the addition of clinical services. Our clinical experts assist providers in adding new services through evidence-based program development. By determining staffing type and ratios, evaluating billing codes and rates, potential client volume, and contracting opportunities, we garner program cost, business impact and overall viability.