Provider Data Management

Data Cleansing and Verification (DCAV) services

Health plans have more data than ever before. But the quality of data, especially information about the providers, is often questionable. Atom Healthcare’s data cleansing and Verification services (DCAV) brings consistency to the health plan’s provider data, is often necessary to bring consistency to health plan’s data, which has been fetched from numerous, disparate data systems and sources.

We provide accurate up-to-date provider information through a combination of data capture and cleansing processes and web search validation, as well as direct outreach to providers to improve provider data quality in the most cost-effective and timely manner.

Credentialing

Provider Credentialing established trust in the minds of a health plan’s members as they can rest assured that the health plan has validated the provider. The process is, however, cumbersome, and requires collection of the provider’s information, validation with primary source verification, and committee review of health provider’s qualifications and experience.

Our Provider Credentialing and Enrollment Services include collection of provider documentation, outreach for missing information, data capture on the health plan’s platforms, primary source verification, and completion of the data for health plan’s review.

Provider Updates and Maintenance

Provider data requires constant updates and maintenance to be accurate. We set up new providers, process changes, terminations, and provider demographic updates with speed and accuracy to improve the overall quality of the provider information.

Provider Recruitment

Provider recruitment and ongoing relationship management is key to ensuring that high-quality physicians are available to your members, thereby enhancing the member experience and assuring the overall success of the health plan.

Our recruitment and relationship management solutions include high quality contact center infrastructure and highly skilled professionals who know how to work with all types of healthcare providers. We answer queries related to the health plan’s contract, and forge strong relationships with healthcare providers who have been recruited.

Benefits

  • Improve provider data accuracy by getting information directly from the provider, rather than a third-party data aggregator

  • Reduces costs associated with annual credentialing processes by as much as 30-40%

  • Mitigates compliance risk from inaccurate provider information

  • Assure Trust to your health plan’s members

  • Forge strong relationships with your contracted physicians


Contact Us for Provider Data Management Services

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