The Challenge
A national dental payer struggled to maintain accurate and complete provider directories. Outdated addresses, phone numbers, roster listing and resource limitations made it difficult to engage dentists effectively. These inaccuracies created compliance risk from network adequacy along with missing providers leading to increased member/employer dissatisfaction. Dissatisfied members often meant dissatisfied employers, which increased the likelihood of employer groups leaving the plan. The payer’s internal processes were too manual and reactive to keep pace with constant provider data changes, which caused the problem to worsen over time.
Why They Turned to HealthLink Dimensions
The payer needed a healthcare data partner with both scale and precision. They sought a partner capable of reducing compliance risk, minimizing member abrasion, and strengthening client retention. HealthLink Dimensions offered more than just raw data. With over 25 years of experience building the Golden Provider Record, HealthLink unifies data from more than 500 continuously updated sources, including both structured and unstructured data. This data is normalized, scored, and validated for accuracy, giving HealthLink a stronger starting point than nearly anyone in the industry for building complete and accurate healthcare provider profiles across the U.S.
The Solution
HealthLink implemented solutions from its Profile and Enrich pillars to address the payer’s challenges. The project began with establishing reliable practitioner and facility demographics, focused on their dental network data. HealthLink’s Network Directory Validation service was implemented with roster management, provider self-attestation and live validation and outreach ensured the hardest to reach dentists could still be verified. This combination of solutions gave the payer both accuracy and confidence in their provider network.
The Results
The dental payer achieved a cleaner, audit ready provider directory that reduced compliance exposure and eliminated ghost networks. HealthLink offered guaranteed improvement in the accuracy of the network through quality SLAs, call tracking, and audit support. Verified contact data improved outreach, making it easier to connect with dentists and build stronger relationships over time. The Provider Attestation Portal streamlined updates, improving efficiency for both the payer and providers, generating self-attested records for hard-to-reach dental practices. The program touched 100% of the provider data records with actionable updates allowing the payer provider service team to focus on at-risk provider data while meeting quarterly validation standards. An enhanced, accurate provider director information strengthened member and employer trust in the plan.
The Takeaway
Accurate provider data is essential for payers who want to maintain strong networks, deliver a positive member experience, and retain employer groups. HealthLink Dimensions helped this dental payer move beyond internal processed by delivering continuously validated data, engagement tools, and audit ready outputs. With better data came stronger provider relationships, improved compliance readiness, and higher satisfaction among members and employers alike.
Provider directories are continuously changing. With shifting demographics of 10-20% of total data quarter over quarter, strictly data driven solutions can still leave risk. Provider engagement through a data plus service model leads to higher quality network data results and provides a partner for compliance and risk management support.
