Provider Data Online Database Overview
Bad data costs health plans millions of dollars each year in unnecessary expenses. In contrast, accurate data can:
- Increase your claims auto-adjudication rates
- Prevent fraudulent claims from being paid
- Increase your plan's coverage and provider density
By leveraging Provider Data Online Database, health plans can cost-effectively and continuously clean, correct, and augment their own provider data to lower costs and drive efficiencies in claims processing, mailings, network management, and other areas, without a large IT or call center effort on their part. With the power of more than 600 sources, provider office verified data, and a host of mission-critical data elements, you can make more accurate business decisions that directly benefit your organization. Even better, you can do this in an instant, when you need it most.
Proprietary Database
Provider Data Online Databaseutilizes a unique data sourcing model and provider outreach data verification program to provide unparalleled provider coverage, data fills, and accuracy. Ingenix relationships provide access to rich repositories of health care provider information. This, combined with the data Ingenix aggregates directly from nearly every federal and state medical licensing and enumeration agency, allow Ingenix to deliver some of the industry’s most complete and reliable data.
Provider Authentication and Recruiting
Provider Data Online Database eliminates time lag. Health plans can research the existence and credentials of a particular provider or create a list of providers to expedite online provider enrollment applications as well as claims adjudication for out-of-network providers. In addition, organizations can use Provider Data Online Database to identify providers that match a desired profile. For example, health plans that need to expand or augment their network use this database to find physicians affiliated with a particular hospital in a geographic area, and hospitals use it to recruit physicians with specialties that they need to complete their service offerings.
Data Augmentation and Confirmation
If your organization is missing data about a particular provider, this sophisticated lookup tool allows you to check your records against the Ingenix database, and provides the missing data to augment into your in-house database. For example, if you have the physician’s name and DEA, Provider Data Online Database can obtain the NPI. In addition, you can use Provider Data Online Database to check the validity of data currently in your database to confirm practice location prior to a site visit.
Fraud Investigation
In an effort to mitigate health care fraud, Provider Data Online Database can be used to research status on provider sanctions and deceased providers. You can also verify valid licenses for particular providers.
