Provider Data Management & Credentialing

Improve member and provider support while eliminating the pain of penalties

In a constantly shifting healthcare environment, provider data management isn’t just a priority, it’s a necessity.

Inaccurate provider data can lead to costly audits and fines, claims reprocessing and dispute resolution, and revenue lost from dissatisfied members and providers. Only proactive updates, secure and automated directory maintenance, and intelligent document management can protect you from the unnecessary business expense that comes from inaccurate provider data—while empowering you to resolve issues now and solve potential operational problems before they arise.

Firstsource’s Provider Data services combine secure data management, leading-edge automation, and skilled personnel to reduce risk and complexity, enhance member and provider satisfaction, and grow revenue through fast, accurate claims processing.

Provider File Demographic Updating

• Keep provider network information up to date
• Reduce risk of fines, sanctions, and litigation

Timely, proactive updates are the only way to ensure that your provider data remains accurate. Firstsource provides online services, documents, and one-on-one assistance to help providers update addresses, specialties, requirements, and other pertinent demographic information.

Our manual and automated solutions work with providers, network managers, and multiple comprehensive data sources to correct outdated information before it can have a negative impact on your reputation or your bottom line.

Provider Directory Maintenance

• Ensure that members can find doctors and get treated
• Protect members from unnecessary medical expenses associated with out-of-network care

Provider directories are an essential resource for members, providers, and payers to manage care and claims. Firstsource directory solutions include validation capabilities and customizable data elements to ensure accurate data is available how and when it’s needed.

Any data discrepancies are resolved by Firstsource’s trained, experienced agents who correct inaccuracies immediately and address root problems that could stand in the way of outstanding member and provider support in the future.

Contract Document Management

• Increase first-pass auto-adjudication rates while shrinking operating costs

Managing data based on hardy copy documents and manually intensive tasks is a path to inaccuracy and inefficiency. Firstsource’s digital mailrooms use high-speed, high-resolution imaging technology to capture and customize data electronically.

Our automated workflows, auto-adaptive machine learning, and secure, centralized data repository ensure fast and efficient data validation, triage, and distribution, to move claims through the system more quickly with less chance for human error.