Solutions for Health Plans
Provider Validation Services
Primary Sourced Validation
Direct outreach to your contracted provider offices and health systems via email, letter, fax and phone, along with convenient validation channels that align to your Providers capabilities and needs.
Configuration Options
Options that align to your network and product requirements.
Superior Data Quality and Results
100% outreach completion.
Over 95% validation data quality.
Full audit capabilities.
Advanced Technology
Data analytics and enrichment, Machine learning as well as Provider Data Management System and EHR integration capabilities.
Pre-validated Provider Data
Save Time and Money
Stay updated with instant access to validated Provider records across the country.
Trust
PRIME Data is Trusted by Top Health Plans.
CMS Mock Audit Preparation
Mock CMS Audits
We have extensive experience in conducting mock CMS audit preparation and validation projects. We work closely with Health Plans to understand the nuances of the audit process and provide results that assist with identifying weaknesses and potential compliance violations.
Special Needs Plan MOC
Online Training
Online Training methodology enables your Providers to complete the specific training required to deliver quality care.
Build competencies
Log attendance lists and incorporate competencies related to specific job functions. Competency modules include Integrity and Compliance, Fraud and Abuse, Cultural Competency, HIPPA and Confidentiality.
We follow-up
We use various outreach methods, like fax, email and phone, to reach your Providers. We track status, and send your Providers a certificate upon completion.
Print-ready Provider Directories
Stay Compliant
CMS mandates that printed directories be made available for patients over 65 years old. We design flexible ready-to-print PDF format directories that help you comply with this regulation.
Accessibility Directories
Our Accessibility Directories are correctly designed, developed and edited to provide all users with equal access to information and functionality.
Integrations
Automated integrations with the PRIME platform can facilitate timely update of the Provider data stored in your Provider Data Management System.
Success stories
Top Health Plans trust PRIME
