Four Provider Data Governance Mistakes
Provider data governance gives you the tools you need to manage your healthcare provider data effectively. Are you making these mistakes?
Health Equity & The Future of Provider Directories
What does the future of the provider directory look like in supporting SDOH? We look at the directions we can go to improve health equity.
Streamlining Non-Par Provider Setup
Non-par provider setup is a challenging process for most health plans. In this post, we examine key best practices to streamline the process.
Provider Directory Review: Oscar
In our first provider directory review, we take a look at what makes for a good provider directory and how Oscar stacks up to those criteria.
Managing Provider Exclusion Lists
Health plans must be careful to manage provider exclusion lists correctly. For government plans, such as Managed Medicaid and Medicare Advantage, there can be stiff penalties for paying providers who appear on an exclusion list. Commercial plans often take the lead from government programs in terms of who they will contract with and pay.
The No Surprises Act for Health Plans
The No Surprises Act creates compliance and financial implications for healthcare providers and health plans. How will it impact your health plan?
How Good is the NPPES Database?
While the NPPES database offers substantial provider information, it must be used carefully if health plans wish to improve provider data.
The Challenges With Provider Data & Legacy Claims Systems
Health plans operating legacy claims systems face particular challenges when it comes to provider data. Here is a rundown of the key challenges and recommendations for addressing them.