Provider Data Management & Credentialing

Our provider data management and credentialing services empowers you with the most updated and accurate provider data available, resulting in better service quality and avoidance regulatory penalties.
Stay Ahead

The problem and the risks are real

  • 78% of privately insured Americans use their insurance carrier’s printed or on-line provider directory to find participating physicians and facilities
  • 30% of all physician primary addresses and more than 70% of physician demographic information change every year
  • 66% of listed providers were not at their listed locations in the first phase of a new provider directory accuracy pilot conducted by CMS
  • Of the 108 provider locations CMS examined, on average, 45% of Medicare Advantage physician directories contained inaccuracies3
  • Two of the largest U.S. health insurers were forced to pay over $38 million in overpayment reimbursements to consumers for out-of-network care – fueling a rash of class-action lawsuits3
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Why Firstsource Healthcare?

Partner of choice for leading Health Plans and Healthcare Services

Our clients include 12 of the top 20 Health Plans nationwide

Data-driven approach & cutting-edge technology

Our solutions are backed by Robotic Process Automation, advanced analytics and more

We service over 50 million covered lives

With our 20+ years' experience in the field, you'll know your customers are in good hands

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