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Provider 411

Unmatched provider research tools. Superior data breadth and integrity. No up-front IT expense or large staff investment.

Public database searches, including government resources, lack comprehensive or consistent provider information. Even worse, manual searches waste valuable time without substantially improving the quality of the results.

Provider 411’s payer-specific views streamline credentialing, claims, provider contracting, provider relationships, case management, and other essential operations. Health plans can personalize views for each user group for further efficiency.

Provider 411 aggregates and compiles provider data from all available government sites, select HealthLink Dimensions data partners, and proprietary primary sources. HealthLink Dimensions also integrates quality scores and other critical but hard-to-integrate areas of information. This 360-degree national overview delivers exceptional breadth and depth for any US-based healthcare provider.

Provider 411 Core Capabilities

  • Provider File Credentialing and Maintenance – Detailed information on almost all US-based providers in a single service. Accelerate setup with all provider data aggregated into a single source organized to optimize provider data processes.
  • Out-of-Network Provider and Claims Management – Speed up data entry for new providers, as well as streamline network expansion, provider price negotiation, and Letters of Agreement (LOA).
  • Provider Communications – Continuously updated provider address and contact information within a single resource that improves provider outreach and engagement.
  • Member Care Coordination – Helps case managers find and contact providers nationwide with critical insights across specialty and common conditions treated. Enhances coordination during and after a member’s discharge and follow-up care.

Provider 411 with Insights

This enhanced version of Provider 411 integrates provider network information and claims encounters with HealthLink Dimensions’ market-leading provider data and data services to help:

  • Reduce Fraud and Abuse – Alerts teams to prevent overpayment for inactive or sanctioned providers who submit inappropriate claims.
  • Simplify Provider File Maintenance – Rapidly identifies and alerts on provider data changes that impact provider contracts, eligibility, and reimbursement.
  • Certified Provider Email Addresses – BPA-certified email addresses for enhanced deliverability and response when reaching out to busy, time-sensitive providers
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