AI Provider Network Management Agent

How Cassidy automates this using AI

Step 1: Trigger on provider intake

The Workflow activates when a new provider submits an application, uploads documents, or authorizes CAQH access automatically creating a credentialing file and pulling baseline data from NPPES and CAQH ProView.

Step 2: Run primary source verification

Cassidy queries state licensure boards, DEA, ABMS/AOA, NPDB, OIG LEIE, and SAM.gov in parallel capturing verification artifacts with timestamps and flagging any red flags like sanctions, gaps, or malpractice history for committee review.

Step 3: Prepare committee-ready files

The Knowledge Base compiles PSV results, attestations, and disclosures into a decision grid. Clean files route for expedited approval while flagged files generate summary packets for full credentialing committee discussion.

Step 4: Execute payer enrollment

Cassidy pre-populates CMS-855 forms for PECOS submission, ensures CAQH authorizations are current, and submits applications to commercial payer portals tracking approval status and effective dates across each line of business.

Step 5: Monitor and maintain compliance

Ongoing Workflows track expirables, trigger 120-day CAQH re-attestation reminders, and calendar Medicare revalidations. Alerts notify the team before licenses lapse, and delegation oversight reports generate automatically for health plan audits.