Payers only maintain data on their existing network and don’t often have complete information on other providers within their region. This puts them at a disadvantage when they want to add to their network, or need to negotiate when their members receive services from them. Some of their members go out of state for specialty services, leaving claims teams to enter new providers into their adjudication system before the claim can be processed.
Provider 411 aggregates and compiles provider data from all available government sites, select HealthLink Dimensions data partners, and proprietary primary sources to provide an online data resourse streamlines credentialing, claims, provider contracting, provider relationships, case management, and other essential operations
See a provider’s full profile of information in one screen including current and former addresses, NPI number, DEA number, licenses for all states, OIG sanctions, and more.
Saves time and improves accuracy of data entry and research by having all information in one place. Reduces burden of searching multiple government sites and provides data points such as former addresses that are not available with internet searches.
Ability to find and export lists of providers in a geographic region to help expand the network or fill network gaps.
Payers that are expanding their footprint gain the ability to quickly identify providers and their contact information to reach out to them and offer them to join their network.
Provider411 with insights has the ability for a health plan to upload their network and get monitoring alerts when certain fields change to help them better maintain their network information.
Provider data is constantly changing and the monitoring alerts allow the payers to be notified when data fields they care about are changed so they can update their databases in a timely manner.