Payer-specific provider directory services, available now for smart organizations seeking streamlined compliance, superior accuracy and low operational expenses
The No Surprises Act (NSA) requires that payers maintain accurate lists of in-network providers. This legislation aims to reduce or eliminate excessive out-of-network billing surprises for patients, backed with stiff penalties for payers who fail to meet its objectives.
Compliance requires multiple complicated tasks:
- An up-to-date database containing all in-network providers, contracted directly or indirectly
- Electronic member access to listings for any contracted provider
- Single-day response for member inquiries regarding provider status
- Validation and review for all in-network providers every 90 days
- Provider directory update implementation within two days after receiving new or revised provider information
Payers have two choices. They can make substantial investments in hardware, software, and staff in a rushed effort to become fully compliant by the January 1, 2022 deadline.
Or they can choose HealthLink Dimensions’ Provider Directory Advantage.
HealthLink Dimensions aggregates and compiles provider data from all available government sites plus high-quality proprietary resources. Advanced analytics measure the quality and accuracy for each record, flagging provider entries for validation and review. HealthLink Dimensions’ Provider Research Center provides live validation with staff trained to review and update provider records. With Provider Directory Advantage, payers gain the ability to deliver national and regional provider databases, fully compliant with NSA requirements. These online directory resources deploy rapidly without the hassle of internal development or ongoing staffing and maintenance.
Comprehensive Payer-Specific Provider Information Solutions
Provider Directory Advantage features a unique three-step process for ongoing 90-day in-network directory verification in accord with NSA requirements:
Step 1 – Digital Verification
Healthlink Dimensions monitors and aggregates more than 500 provider databases, using advanced analytics to identify new, deleted, and updated provider information – quickly, accurately, and efficiently. We also verify this information from independent sources including large health system directories, which in turn helps reduce change reporting burdens for providers.
Step 2 – Provider Self-Verification
HealthLink Dimensions simplifies provider outreach and portal-based data entry to give providers a streamlined, time-efficient pathway to maintain their data. This combination of intuitive user interface and streamlined accessibility for data input helps providers ensure accurate records.
Step 3 – Live Outreach via the Provider Research Center
HealthLink Dimensions maintains an experienced, highly trained team of professionals who verify provider information, as well as monitor and maintain the accuracy of our national provider directory. These staff members reach out directly to any providers that cannot be validated via digital or provider self-verification processes, which creates an additional layer of accuracy that helps health plans meet quarterly compliance requirements.
No Surprises Act compliance doesn’t need to be rushed, complicated, or expensive. Contact HealthLink Dimensions at 404-250-3900 today to learn more about Provider 411, Provider Directory Advantage, and the smarter approach to payer-specific provider directory solutions.