Businesses today depend on clean, accurate data to run effectively and maintain clients.This is also true for insurance providers, who leverage data to process payments, grow their network of providers and give healthcare professionals the information they need to satisfy their patients. Data append and data cleansing services are essential to the success of any insurance company that hopes to maintain a healthy relationship with practitioners.
"Inaccurate information is pandemic across the insurance industry."
Unfortunately, research shows that inaccurate information is pandemic across the insurance industry. In fact, the Office of the Inspector General of the U.S. conducted analysis in 2014 that revealed after calling 1,800 providers listed by more than 200 insurers contracted to provide Medicaid coverage in 32 states, over one-third of health providers could not be found at the location listed by the insurer.
While this research was conducted to shed light on issues surrounding access to healthcare for Medicaid patients, the numbers speak to the data discrepancy that plagues insurers today as well as the need for change. Here are three imperative reasons insurance companies depend on high-quality data:
1. Providers want more consistent communication
First and foremost, medical professionals want to hear more from their insurance providers. According to the HealthLink Dimensions white paper "How to Effectively Communicate with Healthcare Professionals," only 27 percent of respondents receive adequate information from insurance carriers. Further, 36 percent of physicians feel payers could provide more timely updates, and 37 percent rarely hear from insurance providers at all.
The marketing process doesn't end once a provider makes his or her way through the sales funnel. Instead, carriers should provide consistent communication, engagement and proactive customer service to their clients. In order to do so, payers must have access to up-to-date, accurate contact information.
2. Network growth and retention
Moreover, accurate contact data is a key ingredient to network growth and customer retention. Insurance companies should act as partners to providers, aiding them in the process of giving care to patients and acquiring payment. By staying in touch, consistently communicating and proactively reaching out through each step of the care process, insurance carriers can retain providers for a long time. Additionally, accurate contact data is crucial to developing a strong marketing strategy. To grow their network and earn more providers, payers must have the right contact data to empower their sales representatives.
3. Regulations demand accuracy
Finally, maintaining an accurate database of provider contact information is actually not optional. The Center for Medicare and Medicaid Services recently informed qualified health plans on the federal marketplace as well as insurers that provide Medicare Advantage plans that starting in 2016, insurers must provide up-to-date doctor lists for their Medicare Advantage and Healthcare.gov policies.
"A provider directory will be considered up-to-date if it is updated at least monthly and easily accessible when the general public is able to view all of the current providers for a plan in the provider directory on the issuer's public website through a clearly identifiable link or tab without having to create or access an account or enter a policy number. The general public should be able to easily discern which providers participate in which plan(s) and provider network(s). Further, if the health plan issuer maintains multiple provider networks, the plan(s) and provider network(s) associated with each provider, including the tier in which the provider is included, should be clearly identified on the website and in the provider directory," The Center for Medicare and Medicaid Services stated.
With these new requirements in mind, accurate data is not just a marketing necessity, but a mandatory reality. Fortunately, data management services can help insurers maintain accurate databases on a regular basis.