Not knowing what you don’t know can be costly
Something as simple as improperly maintained provider data files can have devastating effects all across the healthcare payer enterprise. Irregularly or poorly implemented maintenance processes can lead to compliance issues, risking massive fines and loss of revenue. And all of that is on top of wasted administrative time and expense, member frustration and associated attrition, and financial penalties, all stemming from inaccurate provider data. In this demanding and highly regulated environment, having inaccurate, incorrect or out-of-date provider data is simply not an option.
Relying on periodic updates at contracting or credentialing time to maintain accurate provider files can leave you without crucial information when you—and your members—need it most. Firstsource’s provider data management solutions reference multiple, comprehensive data sources to access the most up-to-date information available, along with hands-on research into and resolution of discrepancies, to ensure that the data you rely on is data you can trust.
Provider data is only trustworthy when it’s maintained by experts
Provider File Demographic Updating
Firstsource agents and automated solutions keep provider databases up to date for the benefit of members, providers, and regulatory agencies. Firstsource provides online services, documents, and one-on-one assistance to help providers update addresses, specialties, requirements, and other pertinent demographic information. Personal interaction and dynamic intelligence capabilities proactively confirm contact information and assess whether a provider is accepting new patients, maintaining accurate information in a quickly changing healthcare landscape.
Provider Directory Maintenance
Provider directories serve as a convenient resource for members and providers and a crucial one for payers as they communicate with key parties in routing clinical information and managing claims. Firstsource’s directory solutions include validation capabilities and customizable data elements, and a high level of data accuracy is maintained using both automated and hands-on approaches.
Provider Credentialing Document Management
Firstsource avoids inaccuracies in provider credentialing in part by minimizing opportunities for loss or error. High-speed, high-resolution scanners image credentialing documents and store them centrally for ready access on demand. Automatic alerts and notifications ensure that documents remain current and that necessary parties provide updated information as needed so that crucial healthcare management processes aren’t delayed due to inaccurate data.