More than 25 percent of health care provider contact information changes each year, which is why so many companies need help keeping the information up-to-date. When provider information is accurate, claims are processed more effectively, payments to health care providers made more quickly, and important communications are received rather than being re-routed. If you’ve recently received a fax, email or call from Enclarity requesting provider information, we’d like to take this opportunity to explain why we contacted you and why it’s so important that we get your information right.
Click on a question below to be taken directly to the answer:
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 health care provider with whom they do business. These records include your contact information; specifically practice address, phone and fax numbers, and related key identifiers such as National Provider Identifier (NPI) numbers and state license numbers.
Using this information, our customers can pay claims and medical bills submitted by health care 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 other important information.
The problem is that each year, many health care providers move, change their telephone numbers or email addresses, change their 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. And it results in missed communications, slowed or even late payments to you, incorrect information about you on provider directories, and more. According to the U.S. Postal Service, at least 25-30 percent of the demographic/contact information for health care providers changes every year. In fact, bad or outdated provider data costs the health care industry $26 billion annually.
That's why responding to our phone call, fax or email requesting verification of your information is so important. Every year, Enclarity attempts to contact health care practitioners to verify demographic information 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 to better understand why it’s so important that we get your information right.
Enclarity, a LexisNexis Company, is focused on monitoring and reporting of health care provider information for our clients. We solve health care’s provider information problem, delivering correct, current and comprehensive provider information solutions by blending thousands of data sources, advanced analytics, and health care expertise. As a result, we have compiled the largest, most accurate database of medical provider business and professional demographic data in the United States. At Enclarity, we help our clients improve results in many areas, including claims processing, provider directories, regulatory compliance, and marketing optimization.
As the health care industry realigns and consolidates due to initiatives designed to control costs and improve quality of care, the need for correct, complete and comprehensive provider data has become critical.
The nation’s largest health insurance plans, preferred provider organizations, pharmaceutical manufacturers, medical device manufacturers, and pharmacy network companies count on Enclarity. To learn more about Enclarity, click here. Back to top
If we have faxed or emailed you, it is because we need to verify that your fax is secure and can be used for transmitting PHI communication. The American Recovery and Reinvestment Act of 2009 (ARRA) requires that all Personal Health Information (PHI) communication, including prescription renewal requests, must be secure. It's important that you review and confirm or update the provider name, address, phone, fax and any other information included on the form.
If we have called you, we simply want 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. Once your information is verified, we can pass it back to our customers, so they can accurately pay claims, maintain provider directories, or communicate with you regarding such things as for prescription renewals. Back to top
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, which will reduce the number of phone inquiries you receive from various health care business entities trying to update this information. If needed, we will make 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 health care provider directories and prescription renewals is accurate, and make sure important correspondence is sent to your current address. Back to top
Enclarity uses over 1,000 authority sources for the information in our Master Provider Referential Database (MPRD™). Powered by AcuSync®, a proprietary technology developed by Enclarity, we continuously inspect and update every detail of the 6.5 million provider profiles in our database. The authority data sources that we employ to verify information about providers in our database 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 performs more than five million telephone calls, faxes or other type of outreach each year to U.S. health care providers, to further verify the accuracy of our database. Back to top
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
Accurate and up-to-date provider information is essential for our customers, including 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 health care-related businesses. Our customers need accurate provider demographic information that is continuously monitored and updated to run their operations more efficiently, to help assure your practice is promptly reimbursed for services rendered, and that information about your practice and providers is correctly maintained on health care provider directories used by health insurers, health insurance exchanges and preferred provider organizations . Simply put, Enclarity is much better equipped to monitor changes to provider information than each of our customers are, individually.
Our customers use provider information in a variety of ways, including communicating patient prescription data, validating provider identity for claims payments, reimbursing providers for medical bills, updating provider directories, renewing prescriptions, researching health care practitioners to invite them to become part of a provider network, sending important notifications, such as product recalls, and other uses. Back to top
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 health care-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
If we have tried to reach you on more than one occasion and have not left a message, we apologize for any frustration this may have caused. Unfortunately, our call center does not accept inbound calls at this time, so we must attempt subsequent calls until we can reach you. Back to top
Not at all! There are no costs to any provider who wishes to validate their demographic information with Enclarity. Back to top
You can reach Enclarity via fax, email or regular mail:
FAX to Enclarity at (866) 699-0422
Mail to Enclarity at:
Enclarity, a LexisNexis Company
Attn: Provider Data Verification Team
510 First Avenue North
Minneapolis MN 55403
Gladly! Please send us the information for these providers, including their name, practice address, practice telephone, practice fax and NPI number, via FAX to Enclarity at (866) 699-0422 or click here to send us the information via email. This will help us match our records with the additional providers at your location. Back to top
If you receive a letter regarding a provider who no longer practices at your location, the information may simply be outdated. That's one of the key reasons why it’s so important to continuously verify that the provider information in our database is correct and current. Please return this fax stating the provider is not practicing at this location, and we will update our records. Faxes can be sent to Enclarity at (866) 699-0422, or click here to send us an email. Back to top
Please mark on the data verification profile form that the provider is "deceased" and, if possible, include the month and year when the provider was deceased. Then, please fax the form to Enclarity at (866) 699-0422, or click here to send us an email . Back to top
Please write on the data verification profile form the provider is "retired" and, if possible, include the month and year when the provider retired. Then, please fax the form to Enclarity at (866) 699-0422 or click here to send us an email. Back to top
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. You may fax the form to Enclarity at (866) 699-0422, or click here to send us an email and we will update your records with your correct name. Back to top
Enclarity’s commercial database of health care providers is made up of information that is in the public domain. Likewise, our provider data verification program validates information from the public domain. We do not share any non-public information with the organizations that are licensed to use our data.Back to top
To be placed on our "Do Not Fax" list, you may call (612) 746-2853 to contact the support desk or click here to opt-out. Or, you may write ‘Do Not Fax’ on the form we sent you and fax it back to (866) 699-0422. Back to top
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 ensures your provider information is kept correct and current, which means the medical bills you remit to our customers will be paid promptly, and that up-to-date information about you and your practice appears in our customers’ health care provider directories, 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 may quickly become outdated. Health care-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 health care-related business activities that rely on accurate provider data. Back to top
If you prefer to mail your provider verification form instead of faxing it, please send it to:
Enclarity, a LexisNexis Company
Attn: Provider Data Verification Team
510 First Avenue North
Minneapolis MN 55403
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 health care practice, then please let us know via fax to (866) 699-0422, or click here to send us an email. We will immediately add that fax number to our "Do Not Fax" list, and you will never receive a fax from us at that number 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
Typically the CAQH data is only used for credentialing functions. In fact, many health care-related organizations do not utilize the CAQH provider database at all. In addition, the CAQH database does not include all practice location addresses. As a result, it is very difficult for health care organizations to determine if the address they have on file for you is correct and current. Back to top
Enclarity takes data security and identity theft very seriously. Our data center is a HIPAA Security, SSAE-16 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 has achieved URAC accreditation. In addition, we only do business with customers and health care organizations demonstrating proven security measures approved by leading accreditation organizations. Back to top
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 click here to send us an email . Back to top