Provider Data Management
Seamlessly gather, augment, validate and consume accurate provider data.
Precise systematically manages provider data to reduce directory inaccuracies, exposure to regulatory non-compliance and barriers to building robust provider networks.
Better management of provider data leads to
a more efficient healthcare system.
Provider directory accuracy is fundamental to improving health outcomes. Healthcare organizations need provider data accuracy to ensure their networks have the right capacity to treat patients. Payors need provider data accuracy to maintain compliance with data accuracy regulations. Patients look to the directories published by their health plan to inform their care plan.
Keeping pace with rapidly changing provider data is vital.
The regulatory landscape is evolving rapidly. New rules around price and transparency layered on older rules tied to the publication of accurate provider data have left payors and other healthcare organizations exposed to hefty fines and poor patient outcomes. Provider data management is often a manual and incredibly cumbersome process. It is particularly challenging to monitor and maintain because of the vast number of structured and unstructured elements that change frequently. Beyond downstream operational problems, patients are most impacted because provider data inaccuracy impedes access.
With more accurate provider information, patients can have more confidence in, and stronger affinity for, their healthcare organizations. With robust provider data management processes in place, healthcare organizations can make data-based adjustments to their provider networks to ensure they have the right expertise available to best manage their patient populations.
Continuously updated. Ever expanding. Always intelligent.
Healthcare organizations can rely on H1’s powerful provider data management solution to provide current, accurate data on healthcare providers (HCPs), including contact information, affiliation data, license verification, and in-network insurance plan certification. Our redundant validation techniques remove data inaccuracies, paving the way for healthcare organizations to develop robust provider networks that can fully address the needs of their patients. H1 enables seamless management of provider data quality and network accuracy to help members access care and improve outcomes and quality metrics like HEDIS and Stars.
With H1 you can:
Help patients access needed care and reduce global costs and health disparities.
Ensure provider directory accuracy by removing data inaccuracies through validation techniques.
Improve provider outreach, network adequacy and recruitment efforts without additional administrative burden.
Improve the patient experience by enabling access to the right in-network providers and protect them from unauthorized out-of-network billing.
Solve operational challenges and meet regulatory mandates for provider data accuracy.
Ways Payors benefit from H1 for Provider Data Accuracy
Stronger Patient Affinity
Stronger Patient Affinity
We help build your patients’ confidence in, and affinity for, their health insurance organization by reducing provider data inaccuracies.
Better Patient Outcomes
Better Patient Outcomes
We enable better care by making patient referrals to in-network providers more accurate and by improving healthcare organizations’ ability to maintain staffing levels that reflect the needs of patient populations.
Regulatory Compliance Confidence
Regulatory Compliance Confidence
We help healthcare organizations get and stay compliant with data accuracy legislation like the No Surprises Act.