Although healthcare provider data is crucial for the effective operation of health plans, including insurance claims processing and directories, payers continue to struggle with acquiring and maintaining such accurate, complete, and timely data.

Central to the problem is the fact that provider data is continually changing and as a result is nearly impossible to keep up to date. A 2016 IDC Health report notes that 2 percent of provider demographics change each month, an estimated 20 to 30 percent of physicians change affiliations each year, while 5 percent of doctors change their “status”—lose licenses, die, retire or are sanctioned annually.

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