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Keeping provider directory data up to date

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Inaccurate provider data has many downstream impacts for payers, including the risk of publishing provider directories with incorrect information. When provider directories are wrong, members may have to delay treatment, or they may be incorrectly billed at out-of-network rates. For this reason, payers are subject to numerous federal and state regulations intended to drive better directory accuracy.

Availity’s Provider Data Management (PDM) solution helps you address the problem of inaccurate provider directories by fixing the problem at the source—the provider demographic data.

Ensure compliance with provider directory regulations

The No Surprises Act requires payers to conduct an attestation process every 90 days to verify that their provider directories are correct. It was the latest in an ongoing effort by federal and state regulators to reduce directory errors. As a leader in provider data solutions, Availity plays a key role in workgroups related to the provider directory regulatory environment.

Improve provider participation in directory updates

Staff who work in provider offices are the best source for the most accurate, up-to-date practice information, including address, hours, practicing physicians, and more. Availity PDM sits within the workflow of these employees, making it easier for them to validate changes.

Regularly capture and maintain high-quality provider data

Unlike many data sources that only change quarterly or annually, provider data changes often, which makes keeping directories up to date so challenging. Availity PDM regularly scans the healthcare environment to quickly identify changes from a range of sources, including claims and billing data.

Learn more about how Availity can help

Product

Provider Data Management

Maintain accurate provider demographic data and ensure compliance with provider directory regulations.

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Case Study

Reduced Costs, Increased Engagement

Availity helps health plan realize 300 percent first-year ROI

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