You may be wondering why you recently received a telephone call or fax from Enclarity requesting information about you or your provider practice, as well as who we are. These are good questions, and we hope the answers shown below will help you understand why we're doing this, and how working with us will help you.

Click on a question below to be taken directly to the answer:

Background
Who is Enclarity?
Why are you contacting me?
How did you get my information? What are your data sources?
Which source provided my information?
Who uses this information? And why?
How do I benefit from being included in the Enclarity database?
What health organizations want my updated information?
You keep calling me but you don't leave a message. Why?
Will it cost me anything to have my information verified?
We have additional providers in our office who did not receive a data verification profile. How can we add them to your database?
The name on the letter we received is not a provider practicing at my location. What do I do with this information and letter?
The provider on the survey is deceased. How do I indicate that in the data verification profile form?
The provider on the survey is retired. How do I indicate that in the data verification profile form?
The name on the data verification profile form is not my proper name. Where did you get that version of my name?
I do not recall giving Enclarity the permission to use my information. Why are you using my data?
How can I opt-out of receiving future faxes?
What would the consequences be if I choose to opt-out?
How do I get a data verification profile form re-faxed to me?
I'd prefer to mail my provider verification form. Where can I send it?
You sent a fax to my home at night. Why?
Why don't you use CAQH to verify my data instead?
How does Enclarity keep my data safe?
Where is Enclarity located?
How can I find out more?

 

Background

Provider demographic data is a profile about you and your practice. Enclarity's customers include health insurance plans, preferred provider organizations, pharmacy network companies, pharmacy benefit managers, property and casualty insurance carriers, as well as life science companies (pharmaceutical and medical device manufacturers). Our customers maintain contact databases of every healthcare provider with whom they do business. These records may include your contact information and related key identifiers such as National Provider Identifier (NPI) numbers and other related data.

Using this information, our customers can pay claims and medical bills submitted by healthcare providers, maintain provider directories for members to find an in-network doctor, communicate patient prescription information and notify providers of important notices, such as product recalls, prescription renewals or changes you need to know.

The problem is that at least 25-30 percent of the demographic information about healthcare providers changes every year. Providers move, change their telephone numbers or email addresses, professional status (i.e. retire) or records become inaccurate through human error. It's a challenge to our customers to keep this information accurate and up-to-date. It results in missed communications, slowed or even late payments to you, incorrect information about you on provider directories and more.

In fact, bad or outdated provider data costs the healthcare industry $26 billion each year.

That's why responding to our telephone call or fax requesting verification of your information can be so important to you. Below are commonly asked questions and answers about what we do and why. Every year, Enclarity attempts to contact healthcare practitioners to verify demographic data regarding your office location(s). By taking a few minutes to verify that your practice information is current, your information can be promptly updated in our database.

So please read on. We hope you'll better understand why this is so important to you, and give you confidence that working with Enclarity is the smart thing to do.

Listed below are some of the most commonly asked questions about this initiative. If you have additional questions, please contact us at (612) 746-2853 or providerhelp@enclarity.com. Back to top

Who is Enclarity?

Enclarity solves healthcare's provider information problem by compiling the largest, most accurate and current medical provider database. Seven of the 10 largest health insurance plans, four of the 10 largest preferred provider organizations and two of the largest pharmacy network companies count on Enclarity. Its solutions improve claims processing, provider directories, prescription renewals, regulatory compliance and marketing optimization. To learn more about Enclarity, click here. Back to top

Why are you contacting me?

The ARRA Act requires that all Personal Health Information (PHI) communication, including prescription renewal requests, must be secure. If we have faxed you, it is because we need to verify that your fax is secure and can be used for transmitting PHI communication. It's important that you review and confirm or update the provider name, address, phone, and fax included on the form. If we have called you, we are contacting you to verify that you are practicing at a location we have listed for you in our database. We want to ensure that the address, phone, and fax are correct for that location. Because demographic information about healthcare providers changes frequently, we are checking to see if the practice location that we have in our database is accurate or needs to be updated. Once your information is verified, we can pass it back to our customers, so they can pay claims, maintain provider directories or communicate with you, such as for prescription renewals. Back to top

How did you get my information? What are your data sources?

Enclarity uses nearly 1,000 authority sources for the information in our Master Provider Referential Database. Powered by AcuSync®, a proprietary technology developed by Enclarity, we continuously inspect and update every detail in each of the 140 million provider records in our database, utilizing these authority sources and more.

Our authority data sources include public information, such as state license records, DEA and NPI numbers, ZIP codes and more. We also use verified commercial information and proprietary data. This information is thoroughly scrutinized before it is accepted for use in our database.

In addition, Enclarity makes or sends over two million telephone calls and faxes each year to U.S. healthcare providers, to further verify the accuracy of our database. Back to top

Which source provided my information?

It is likely that your information was obtained from multiple sources, including those noted in the answer above and data files submitted by our customers. Back to top

Who uses this information? And why?

Enclarity's referential provider demographic data is trusted and used by more leading healthcare payers—including health insurance plans, PPOs, pharmacy network companies, pharmacy benefit managers, property and casualty insurance carriers and life science companies—than any other solution. Our customers include seven of the 10 largest health insurance plans, four of the 10 largest PPOs and the two largest pharmacy network companies.

Accurate and up-to-date provider information is essential for our customers. Examples include communicating patient prescription data, validating provider identity for claims payments, reimbursing providers for medical bills, updating provider directories, renewing prescriptions, researching healthcare practitioners to invite them to become part of a provider network, sending important notifications, such as product recalls, and many other uses. Back to top

How do I benefit from being included in the Enclarity database?

By taking a few minutes to verify your practice information with us, we'll be able to confirm that the data about you is accurate and up-to-date and it will reduce the number of phone inquiries you receive from various healthcare business entities trying to update this information. Or, if needed, we can make any corrections or updates to your record in our database. With your help, our customers can pay claims and medical bills more quickly, reimburse your practice for bills that you submit, assure that your address and contact information on healthcare provider directories and prescription renewals is accurate and up to date, and that important correspondence is sent to your current address. Back to top

What health organizations want my updated information?

Our customers include health insurance companies, PPOs, pharmacy network companies, pharmacy benefit managers, select property and casualty insurers (typically workers. compensation and automobile insurance carriers), life science companies and other similar healthcare-related businesses. These organizations license data from Enclarity to validate provider identify and directory listings, improve claims data, increase operational productivity and more. You can learn more about Enclarity and its array of provider data solutions here. Back to top

You keep calling me but you don't leave a message. Why?

You may have noted that we tried to reach you by telephone on more than one occasion, and that our call center simply did not leave a message. We apologize if this has caused you frustration. Unfortunately, our call center cannot accept inbound calls at this time. For this reason, we must attempt subsequent calls until we can reach you. Back to top

Will it cost me anything to have my information verified?

Not at all! There are no costs to any provider who wishes to validate their demographic information with Enclarity. Back to top

We have additional providers in our office who did not receive a data verification profile. How can we add them to your database?

Please send us the information for these providers, including their name, practice address, practice telephone, practice fax and NPI number. This will help us match our records with the additional providers at your location. Back to top

The name on the letter we received is not a provider practicing at my location. What do I do with this information and letter?

This is the address that we have on record for you. If we are in error, we sincerely apologize. One of the key reasons why we verify our provider data is to keep our database correct and current. Please return this fax stating the provider is not at this location, and we will update the record in our database. Then, please destroy this correspondence. Back to top

The provider on the survey is deceased. How do I indicate that in the data verification profile form?

Please mark on the data verification profile form that the provider is "deceased" and be sure to include the month and year when the provider was deceased. Then, please fax the form to Enclarity at (866) 699-0422. Back to top

The provider on the survey is retired. How do I indicate that in the data verification profile form?

Please write on the data verification profile form the provider is "retired" and be sure to include the month and year when the provider retired. Then, please fax the form to Enclarity at (866) 699-0422. Back to top

The name on the data verification profile form is not my proper name. Where did you get that version of my name?

The name shown on the form you received is the name we have for you in our provider database. Please submit the corrected form with the name as you would like it to appear, and we will update your records with your correct name. Back to top

I do not recall giving Enclarity the permission to use my information. Why are you using my data?

The Enclarity provider data verification program validates public domain information about healthcare providers, including you. Like many companies, Enclarity has a commercial database of healthcare providers that we license to healthcare-related organizations. Enclarity is not unique in this respect. Many companies collect, license and publish provider data. Back to top

How can I opt-out of receiving future faxes?

You may call (612) 746-2853 to contact the support desk or click here to opt-out and be put on our "Do Not Fax" list. Back to top

What would the consequences be if I choose to opt-out?

By choosing to take a few minutes to verify your practice information with Enclarity, we will make any corrections that you request about your record in our Master Provider Referential Database. This can ensure that your provider information is correct and current.

This way, you can have greater confidence that medical bills you remit to our customers will be paid promptly, and that the information about you and your practice on our customers. healthcare provider directories is accurate and up-to-date, which can help to drive more business to you.

However, if you opt-out of receiving future faxes from Enclarity, the demographic data that our customers need to communicate with you will age. Healthcare-related organizations need to have correct and current data about you to pay claims promptly, send correspondence to your current address, renew prescriptions and publish accurate provider directories. If you choose to opt-out from participating in our provider data verification program, you put yourself at risk for these, and other, initiatives reliant on accurate provider data. Back to top

How do I get a data verification profile form re-faxed to me?

Call (612) 746-2853 or contact us via e-mail at providerhelp@enclarity.com. Back to top

I'd prefer to mail my provider verification form. Where can I send it?

If you prefer to mail your provider verification form instead of faxing it, please send it to:

Enclarity, Inc.
Attn: Provider Data Verification Team
510 First Avenue North
Suite 520
Minneapolis MN 55403 Back to top

You sent a fax to my home at night. Why?

It is never our intention to send a fax to your home. If we reached your home fax and it is not a fax used to support your healthcare practice, then please let us know. We will immediately add that fax number to our "Do Not Fax" list, and you will never receive a fax from us again. You may also want to check your NPPES (National Plan and Provider Enumeration System) NPI (National Provider Identifier) information. It's very likely we are using a fax number that you listed when registering for your NPI. In addition, we are also making adjustments to our fax process to regulate the traffic so that faxes will only occur during regular business hours. Back to top

Why don't you use CAQH to verify my data instead?

Many healthcare-related organizations do not utilize the CAQH provider database. In addition, their database does not include all practice location addresses. As a result, it is very difficult for healthcare organizations to determine if the address they have on file for you is correct and current. Back to top

How does Enclarity keep my data safe?

Enclarity takes data security and identity theft very seriously. Our data center is a HIPAA Security and SAS-70 Type II certified facility with extensive security controls and protocols in place. Our systems and procedures undergo rigorous annual security audits, and Enclarity is currently receiving URAC accreditation review. In addition, we only do business with customers and healthcare organizations demonstrating proven security measures approved by leading accreditation organizations. Back to top

Where is Enclarity located?

Enclarity is headquartered in Aliso Viejo, Calif., and has a development and customer service office in Minneapolis, Minn. Back to top

How can I find out more?

We want to thank you for replying to our provider verification faxes or calls. By responding with your approval and/or any corrections, our clients can offer better service to you. Should you have any questions, please contact our support center at (612) 746-2853 or email us at providerhelp@enclarity.com. Back to top