Inaccurate provider data costs payers significant dollars and time

From marketing and sales to data management, the relationships health payers have with healthcare providers are vital to their business. However, as physicians shift specialties and change affiliations, it’s all too easy to lose track of them.

Consider the fact that the average healthcare provider database changes 2 to 3 percent monthly, translating to 24 to 36 percent data degradation annually. What’s more, 5 percent of providers change their status each year, while 30 percent change their hospital affiliations and 20 percent move to a new location.

There are many reasons why payers need clean provider databases. Inaccurate and out-of-date provider data can negatively impact your business in these critical ways:

  • Unclean and low-quality databases can account for 15 to 20 percent loss of a company’s operating revenue
  • Reduced auto-adjudication rates
  • Increased manual claim processing
  • Higher 1099 fees
  • Increase in operational costs
  • Federal or state fines for non-compliance with CMS mandate of  accurate provider directories

Building up your network

A lack of up-to-date contact information also causes communication breakdown with providers. In fact, in a recent survey physicians told HealthLink Dimensions that they would like to receive more frequent communications from payers. Whether you need to maintain transactions, contact your network about important changes or are looking to expand the number of physicians you work with, HealthLink Dimensions has the data solutions you need to stay in touch.

Physician Email: With this database, you have access to a more efficient, affordable and preferred method of contacting physicians than direct mail.

Healthcare Provider: Looking for new physicians and other healthcare providers? This list provides all key contact details for more than 2.7 million providers.

Physician Network Insight: Going further than just finding contacts, you can learn which providers are not on your network to identify potential new markets in which to conduct business.

Keeping data clean

You have to keep your data clean and up-to-date in order to maintain maximum efficiency. With this in mind, we offer Data Cleansing and Data Appending services. Inaccurate data can lead to delays in processing claims, along with increased operating costs. With our services, you can:

  • Eliminate duplicate records
  • Clean up corrupt data
  • Validate and correct contact information
  • Add new data related to a healthcare provider

Making data management easier

With the constant rate of change among healthcare providers, it can be tricky not to fall behind. That’s why we offer services to make maintaining data easier:

Provider Research Portal: A clean and accurate database shouldn’t be a challenge to sort through. Our SaaS Provider Research Portal allows your employees to easily search and verify information on key physicians.

Cloud Services Web API: With any new adjustment, such as a change of address, you want to be able to update all your databases quickly and efficiently. Our real-time Web API makes it easy to pull records from our lists.