In a world of constantly changing provider information, it’s more important than ever to have a fast, automated, trusted solution to keep everything correct and current. More than 25 percent of provider demographic information changes each year. As a result, more than 40 percent of a typical payer’s provider records contain inaccurate or missing information.

 

This translates into hundreds of thousands, even millions of dollars of wasted operational expenses due to errors, rework, penalties and staff inefficiencies. And it’s why Enclarity ProviderPoint Web Services can be such a powerful solution to a constant challenge for healthcare payers.

 

With Enclarity ProviderPoint Web Services, you can send one or more provider records from your systems directly to Enclarity, and receive a fully corrected and augmented record back in real-time that can be deployed to your internal systems. Using accepted XML, SOAP and other common technology standards, ProviderPoint Web Services automates the transfer, cleansing and augmentation of your provider files.

 

ProviderPoint Web Services cleans and enhances your provider files with information from Enclarity’s Master Provider Referential Database, which uses Enclarity’s innovative, proprietary AcuSync® process to leverage thousands of referential and transactional data sources. When Enclarity receives your Web services request, ProviderPoint Web Services uses AcuSync to standardize, cleanse and augment the provider record – identifying and replacing inaccurate, duplicate and incomplete fields, matching and joining data from different sources.

 

Now you can have an automated and systematic way to keep your provider information accurate and up-to-date on a transaction-by-transaction basis.

 

 

How it works:

 

• Client generates a provider output record in need of verification, augmentation and/or correction
• Data is sent through Enclarity’s Web service technology for processing
• Client’s provider record is processed immediately upon receipt and returned in seconds to client’s system
• Client’s system (provider file) applies the verified, corrected data along with augmentation of additional data elements

 

ProviderPoint Web Services is the next generation of ProviderPoint, which 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 offers reliable, up-to-date information by continually updating our Master Referential Database and the analytical science used to create it, and systematically verifying provider data via phone calls
• Comprehensive: Enclarity offers a wide array of information – demographics, key identifiers, including NPI numbers as well as credentials – about all types of healthcare providers including doctors, dentists, chiropractors, physical therapists, facilities, hospitals, labs, pharmacies and others

 

Be confident your operations team has the information they need in real-time

 

ProviderPoint Web Services gives you an unrivaled depth, breadth and quality of information leveraging the power of the Internet to deliver real-time provider data in a way that is easy to for you to integrate and use. Only ProviderPoint Web Services delivers all the information you need to know about your providers in real-time, and enables you to manage its integration so you know that your information is accurate, up-to-date and properly integrated into your operations.

 

Enclarity’s clients chose ProviderPoint for many reasons:

 

• Its proven value in many applications, including:
• More efficient claims processing with improved financial accuracy
• Better network analysis and management
• Improved communication with providers
• Reduced costs associated with mailings and phone call volume
• Improving customer, member and provider satisfaction
• Increasing staff productivity in claims, customer service, provider data maintenance, IT and other areas
• The creation of persistent identifiers that enable provider tracking without a legacy indicator
• Confidence scores, verification indicators and the ability to apply custom business rules to ease integration and establish next steps
• Implementation and integration expertise, and ongoing support from an assigned Account Management team
• The availability of related solutions, including Enclarity ProviderLookup®, our Web browser-based research solution that enables payers to access the industry’s most accurate and up-to-date source of provider information in real-time

 

The quality of your provider information drives your operational results. Now you can cleanse and augment your provider file in real-time with ProviderPoint Web Services. Powered by Enclarity, you can be confident that your provider information will be right today and tomorrow.