The American Medical Association and LexisNexis have launched a new portal intended to increase the accuracy of provider data in payer directories.
The Verify Health Care Portal leverages the LexisNexis Provider Data MasterFile, which incorporates more than 2,000 sources of data covering more than 8.5 million U.S. providers.
Tom Suk, senior director of product management at LexisNexis, contends that this referential database offers the most complete and current provider data in the healthcare industry.
The organizations say the portal is backed by technology that is able to pre-fill, collect, monitor, cleanse and update database information in real time.
Suk sees the AMA and LexisNexis partnership taking advantage of the organizations’ respective strengths, including the AMA’s physician resources and capabilities of its wholly owned subsidiary, AMA Business Solutions, as well as LexisNexis Health Care’s analytic technology.
Obtaining accurate provider data and updating practice information is a significant challenge for payers. In addition, physician offices often receive repetitious data verification requests from health plans, resulting in administrative burdens and workflow disruptions.
“For physicians and their practice staff, being able to verify or update their practice data in an easy and seamless way is a step in the right direction,” says Laurie McGraw, senior vice president of health solutions at AMA. “The Verify Health Care Portal provides a friendly, intuitive interface where physicians or practice staff update directory data once, for all of their participating health plans.”
Last November, AMA and LexisNexis announced the collaboration in an effort to streamline the process of maintaining accurate and up-to-date network directories that meet the needs of patients, physicians and payers.
As Suk points out, federal and state mandates on provider directory accuracy require health plans to make regular updates to their data. Towards that end, the Verify Health Care Portal conducts multi-channel campaign outreach to providers using email, fax, phone calls and direct mail. However, he contends that LexisNexis’ analytic technology eliminates the need to constantly barrage doctors’ offices with data queries.
“We use analytics, predictive modeling and claims to offer better outreach to physicians,” adds Suk. “We’re actively monitoring and filtering activity so that we can make smart outreach to the providers.”
Ultimately, a portal is not the sole solution to the problem of inaccurate provider data. “Unless you support it with analytics and a database to confirm it, self-reported data alone can be fraught with errors,” Suk concludes, who emphasizes that what’s critical is “ensuring that the data that’s captured on a portal is in fact still correct."
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