Healthcare Provider Data Management: Is Your Data Collection Efficient?

Are you finding it more difficult than ever to accurately maintain provider information? Is your company struggling to stay compliant with CMS regulations and concerned about potential audits? You need a comprehensive approach to data validation as part of an accurate and efficient healthcare provider data management strategy.

PRIME’s provider data validation solution helps organizations achieve efficient, automated updates to their provider database management system and can reduce the operational overhead associated with limited integration or manual data entry of your Provider Data Management System (PDMS).

What is Provider Data Management in Healthcare

Healthcare Provider Data ManagementProvider data management (PDM) enables health plans, care systems and hospitals to track, centralize, and manage provider data in order to improve accuracy, leading to improved member and provider satisfaction.

A strong provider data management system automates and simplifies the way health plans validate and maintain provider data and directories. It also increases provider data quality and helps health plans:

  • Stay current with frequently changing provider information such as clinical focuses, affiliations, appointment availability, and coverage options.
  • Effectively perform core business functions.
  • Mitigate compliance risks.
  • Productively leverage integrated networks.

How PRIME Hub Supports Healthcare Provider Data Management Solutions

As part of a robust healthcare PDMS, PRIME Hub:

  • Automates the aggregation, collection of, and entry of provider data into the provider data repository.
  • Scans through provider data for erroneous or duplicate source data.
  • Supports process efforts that ensure that health systems and providers attest to their data’s validity or update accordingly. Validated data includes personal information, specialties, languages spoken, ancillary information, and board certifications. Demographic data quality and specifics like wheelchair accessibility are also validated.
  • Integrates collected data with a client’s PDMS in a timely manner.

Most health plans need the quality of their PDMS maintained on a daily basis but don’t have the internal resources necessary to do the work. PRIME Hub, through its provider data services, ensures that the data within PDMS is reviewed daily (or as required), helping providers mitigate compliance risks as well as ensuring that members are provided updated or accurate information.

Key capabilities of PRIME’s value to improving the quality and timeliness of the data residing with your PDMS include:

  • Direct outreach via telephone, portal, and integration.
  • Configurable workflows and prioritization by specialties and group size
  • Inbound call handling and scheduled call-backs.
  • Custom script design.
  • Dashboard KPIs and operational reporting.
  • Transparent audit capabilities.

If you’re looking for a way to ensure your provider data is complete, timely, and accurate, PRIME’s solutions offer the high-quality data validation services you need. To learn more about how PRIME can support your healthcare provider data management solutions, contact us today.