Accurate and up-to-date provider directories are crucial for many healthcare payers. They're an important communication vehicle for health insurance plans, PPOs and others to maintain strong relationships with both members and providers. But many provider directories contain inaccurate and out of date information. Wrong addresses, doctors who have left practices, sanctioned providers, incorrect phone numbers and other errors frustrate members and damage provider relations. They can lead to a costly research and correction process, more phone calls to answer and a weakened brand. They can even cause risks to NCQA accreditation and contribute to policy cancellations.

 

Manual corrections to provider directory inaccuracies typically cost $10-20 per incident. Enclarity's research reveals that 30-40% of payers' provider records have inaccurate or missing records. It means that a payer with 100,000 providers would spend $300,000 to $800,000 to fix those files once. But, because more than 2% of provider demographic information changes each month, more than half of that investment would need to be repeated each year. And, since about 5% of incoming phone calls typically relate to directory information, the full costs of dirty data are even higher. The associated member and provider dissatisfaction is a significant issue for your business.

 

NCQA accreditation requires validation of provider information and access in order to meet the standards of "Access & Service and Qualified Providers". NCQA is considered the seal of approval for a higher performing health plan. As a result, because the quality of your directory information puts your ability to meet this accreditation standard at risk - it puts your competitive advantage at risk, too.

 

Inaccurate directories cause another significant business risk. The dissatisfaction and even loss of a large client due to complaints about directory information is a very real concern. When you consider the potential revenue lost from even one large client, keeping your directory accuracy in peak condition has true bottom line value.

 

You need an easy, comprehensive way to correct your provider directory inaccuracies and to keep your directories accurate and up-to-date. The good news is that there is such a solution. We call it Enclarity. By offering a rapid and highly accurate way to cleanse, standardize and augment provider files and keep them that way with our ProviderPoint® solution, we're making accurate provider directories reality. You'll experience dramatic improvements in operating efficiency from fewer corrections to make, fewer calls and complaints, as well as better client, member and provider satisfaction. Powered by Enclarity, you can be confident that your provider directories are right - today and tomorrow. And that can be a significant competitive edge.

 

For those needing to research individual providers, our Web-based ProviderLookup™ solution enables you to rapidly assist members and providers. In addition, ProviderLookup makes it a snap to verify and update records via easy, online access to demographics, key identifiers and medical credential information for over 4 million providers.

 

Enclarity solutions can remove one of the big stumbling blocks to member and client satisfaction, inaccurate directory information. By outsourcing your provider information to the industry leader, you can transform your directory accuracy and realize new value across your organization. It's not a dream. It's not the future. Accurate Provider Directories. Available from Enclarity right now.

 

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