Build the Provider Portal
Learning Objectives
After completing this unit, you’ll be able to:
- Define the Provider Portal.
- Describe how providers and caseworkers share information and process referrals.
- Explain the steps for setting up the provider portal.
- List the steps for setting up referral authorizations.
Manage Referrals with the Provider Portal
One of the main challenges agencies face when working with providers is the absence of a common platform to communicate and collaborate.
- Caseworkers have to share important referral information and keep track of the referred constituent’s progress toward improved outcomes.
- Providers must view referral details and provide updates about the delivered services.
Without this connection, caseworkers are often left in the dark about the outcome of the referral, and providers don’t receive timely payment for their services.
Because collaboration is key to successful referrals, Provider Management offers an Experience Cloud template to quickly set up an online Provider Portal. This portal centralizes the entire process of referral transmission, authorization, session enrollment, and service delivery tracking. Here’s an example portal home page on a Provider Portal Experience Cloud site.
The screen capture shows a list of all referrals and a Chatter newsfeed for communicating. Through the portal, providers can:
- Add and update basic information about their services and accreditations.
- Review and accept referrals.
- Create and manage benefit schedules.
- Record constituent attendance.
- Communicate directly with caseworkers.
The portal connects to your agency's Salesforce org data, enabling caseworkers to authorize services and benefit schedules and to receive real-time information about the status of referrals.
Next, follow Connor and Steve to learn how the Provider Portal enhances their experience.
Receiving the Referral
After caseworker Connor submits Steve's referral to the Cosville Grief Counseling Center, an employee at the counseling center logs into the portal. The example screen shows all the current referrals.
On the Home page, the employee sees the new referral that Connor submitted.
They open the referral to review the details about Steve, his situation, and the requested service, determining that the Cosville Grief Counseling Center is well-suited to help Steve.
To seek approval from the agency and start providing services, the employee selects Request Authorization.
To note, an agency may receive requests from multiple providers. So it’s up to the caseworker to review each request and grant authorization to the most suitable provider.
Authorizing the Referral
Back at the agency, Connor receives a notification of the authorization request.
He reviews the details and, satisfied with the provider's suitability, selects Authorize Referral on the referral record to approve the request. When a caseworker accepts or denies the authorization, an automatic message in the Chatter feed of the portal notifies the provider.
Enrolling the Client
Once the referral is authorized, the provider employee gains access to Steve's account record. On the Clients tab of the Provider Service Portal, they can view Steve’s assigned benefit details, including the number of sessions for which he’s eligible.
To schedule Steve’s counseling sessions, the provider employee selects Enroll on the Benefit Disbursement tab and chooses benefit sessions from the list.
For each session enrollment, the system automatically creates a Benefit Disbursement record. If the provider hasn't set up any sessions yet, they can create a new Benefit Schedule and submit it for agency approval.
Tracking Attendance and Progress
On the Attendance tab, the provider can see a list of all the sessions they manage. As Steve progresses through the grief counseling schedule, the provider tracks his attendance in the Disbursement Status field of each session.
When the provider changes the attendance status to Completed, the system updates the benefit disbursement records with the disbursed quantity of the benefit. This way, Connor can keep an eye on Steve’s progress.
At any point in the process, providers can correspond directly with the agency by using the Chatter feed in the portal.
This might include giving updates about the constituent’s progress or asking questions to ensure the best possible outcome for the constituent.
Completing the Referral Process
After Steve finishes his last grief counseling session, Connor updates the care plan to indicate that Steve has received the benefit. Connor also notifies the accounts payable officer at the agency to initiate payment to the Cosville Grief Counseling Center for the delivered services.
Success! The Provider Portal helps constituents like Steve receive the support they need by streamlining common referral tasks for caseworkers and providers.
Set Up the Provider Portal
You now know how the provider portal strengthens the agency-provider connection with built-in information sharing and authorization approval tools. Of course, creating the portal requires a little setup, but the good news is that you can configure the site without writing a single line of code.
Provider Management provides an Experience Cloud template called Service Provider Portal with all of the pages for managing provider information, processing referral requests, and tracking service delivery. Customize this site to meet the needs of your agency, or integrate the capabilities into any of your existing Public Sector Solutions Experience Cloud site templates.
To create the site, follow the guided setup to specify the site URL, add site members, and configure sharing settings to assign access to the Salesforce data. You can also turn on Chatter feed tracking so that providers can ask questions about a referral and share updates, while caseworkers receive notifications when referral-related data changes, as with updates to benefit assignments.
To learn more about setting up the provider portal site, view the Build a Provider Experience Cloud Site in Public Sector Solutions article in Salesforce Help.
Configure Provider Referral Authorization
To facilitate the referral authorization process, use the Authorize Referral for Provider Salesforce flow. This flow updates the authorization status of referrals and shares information from benefit assignment and account records with the provider. Add a custom action that caseworkers can use to quickly authorize referrals from the referral record.
To learn more about setting up referral authorizations, view the Configure Referral Authorization Salesforce Help article.
Back in Cosville, Connor marvels at how easily he can identify the right provider and effectively collaborate with them to help Steve. As the agency begins to build out a strong network of providers, he knows these partnerships will go a long way in alleviating many problems that constituents face throughout the community.
In this module, you learned how Provider Management helps caseworkers connect with providers, streamline referrals, and gain real-time insights into constituent progress. Now, it’s time to put this powerful solution to work for your agency.