Provider information is constantly changing. With physicians and other providers moving and working from multiple locations, more than 25 percent of healthcare provider demographic information changes each year. The result: between demographic changes and other data, more than 40 percent of a typical healthcare payer’s provider records have missing or inaccurate information. That’s why Enclarity ProviderPoint is so important.
The industry standard solution for healthcare provider data cleansing, augmentation and integration
ProviderPoint is a proven, powerful hosted solution that gives you a systematic way to keep your provider information accurate and up-to-date while saving you the cost and time of a significant ongoing project. It delivers an unrivaled depth, breadth and quality of information in a way that is easy to for you to integrate and use. ProviderPoint is trusted by more healthcare payers than any other solution because it supplies information that is:
- Correct: Enclarity delivers the highest quality healthcare provider information by blending thousands of data sources, sophisticated analytics and healthcare expertise
- Current: Enclarity provides reliable, up-to-date information by continually updating its Master Referential Database and the analytical science used to create it, and systematically verifying provider data via phone calls
- Comprehensive: Enclarity provides a wide array of information – demographics, key identifiers including NPI numbers and credentials – about all types of healthcare providers including doctors, dentists, chiropractors, physical therapists, facilities, labs, pharmacies, and others
Be confident your operations team has the healthcare provider data they need
Only ProviderPoint delivers all the information you need to know about your providers, and enables you to manage its integration so you know that your information is accurate, up-to-date and properly integrated into your operations.
ProviderPoint cleans, augments and enhances your provider data files with information from Enclarity’s Master Provider Referential Database, which our AcuSync®
process to leverage thousands of referential and transactional data sources. AcuSync uses advanced analytical and database methods to efficiently and reliably standardize, match and join healthcare provider data from different sources, and then produce a provider profile that contains the best available information.
When Enclarity receives your provider data file, ProviderPoint uses AcuSync to cleanse the provider file – identifying and replacing inaccurate, duplicate and incomplete provider records. It also augments the provider file with additional data attributes. Enclarity’s data scientists work with you to establish business rules that govern what updates, corrections and augmentations happen automatically, and where your staff’s expertise will come into play. After those rules are applied, ProviderPoint delivers a clean healthcare provider file ready for easy integration into your systems.
Enclarity’s clients chose ProviderPoint for many specific uses, including:
More healthcare payers trust ProviderPoint than any other provider information solution
Frost & Sullivan, a leading global growth consulting and IT analyst company selected ProviderPoint as the winner of its Global Excellence in Healthcare Information Technology Product of the Year Award. In its report, Frost & Sullivan stated that ProviderPoint gives healthcare payers a unique competitive advantage, and lauded its impact in enabling accurate provider information and increased transparency within the healthcare industry.
ProviderPoint has proven its value
across many functional areas and operational metrics such as:
- Higher auto-adjudication rates with improved financial accuracy
- Reduce complaints about the accuracy of provider directories Enable better network analysis and management
- Improve communication with providers
- Reduced costs associated with mailings and phone call volume
- Identify potential fraud situations and inappropriate billing practices
- Strengthen business intelligence and data analytics reporting for provider outcomes
- Reduce time to integrate external network information
- Improve compliance, certification and quality metrics related to provider information
- Overall improvement in customer, member and healthcare provider satisfaction
- Save time and money by increasing staff productivity in claims, customer service, provider data maintenance, IT and other areas
With ProviderPoint, you will enjoy many advantages over reactive provider data management efforts such as:
- The ability to predict and measure improvements in information quality and the associated return on investment
- NPI Type 1 and Type 2 information, including accurate matches of Type 1 numbers to individuals, matches of sub-parts to parent to connect all NPI numbers associated with a Type 2 entity, and taxonomy information
- The creation of persistent identifiers that enable provider tracking without a legacy indicator
- Updates on a frequency that meets your business needs, with fast turnaround time, confidence scores, verification indicators and the ability to apply custom business rules to ease integration and establish next steps, including ProviderPoint Web Services
- Implementation and integration expertise, and ongoing support from an assigned Account Management team
- The availability of related solutions, including:
- Enclarity ProviderLookup®, our Web-based solution that provides claims staff, adjusters, customer service and others with a single source of information about individual providers from our Master Provider Referential Database of data on over 6.5 million providers.
- Provider SelectFile® offers subscription access to the provider information you need - by provider type, geographic region and information type
- ProviderPoint for Claim Cleansing – permits healthcare payers to automatically validate and correct key issues on claims, and stay alerted that research is needed about the provider (rendering, billing or referring) as each claim is submitted.
- ProviderPoint for Claims Indexing – identifies and links unique healthcare providers across claims stored in databases or a data warehouse, regardless of changes to name and business affiliation, TIN, Provider ID, practice or billing information over time.
- ProviderPoint for Life Sciences – the most advanced provider data cleansing, augmentation and integration solution for medical device and pharmaceutical manufacturers.
- ProviderPoint Network Optimization Services – a hosted solution that gives healthcare payers accurate and up-to-date insight analyze overlaps and gaps within their provider networks, competitive network analysis and comprehensive provider information to fill those gaps.
- ProviderPoint Data Integration Services – payers can now integrate their provider data into one unified ‘golden record’ across all systems and databases, assuring consistency and accuracy for reporting, transactions, analytics and directories.
- ProviderPoint Web Services – an automated, real-time provider data cleansing service for payers with large provider files needing frequent data cleansing and augmentation.
- Enclarity Email Append – the only email service designed to offer healthcare payers a reliable physician business email address. An unlimited annual use license gives payers extensive email coverage of their physicians eliminating the need for paper mailings to a majority of individual providers.
- Enclarity Physician Office Attributes – a service option for Enclarity ProviderPoint and Provider SelectFile, Enclarity Physician Office Attributes lets payers access more detailed information on physician offices.
- NPI Match® – our solution for fast, accurate and affordable NPI matching and crosswalking.
The quality of your provider information drives your operational results. It can work for you, or against you. Powered by Enclarity, you can be confident that your provider information will be right today and tomorrow. Make ProviderPoint’s correct, current and comprehensive information your competitive edge. Right now.