PRIME by Atlas Systems, combines sophisticated technology, well-defined processes and highly trained, specialized staff, to deliver industry-leading accuracy levels, through direct, primary source data validation. PRIME data validation services are designed to meet your business requirements, and can be delivered on a one-time or ongoing basis. Now, keep your members satisfied by the accuracy of your provider directory data.
Inaccurate network data can lead to dissatisfied members
The dynamic, complex and competitive health plan market place has placed significant challenges and demands on managing your provider data asset. Narrow networks, market expansions and mergers, the Affordable Care Act and other forces have accelerated the volatility of managing provider information.
The struggle to enforce provider self-reporting and compliance has become more difficult, often for the same reasons. Nonetheless, health plans need to be vigilant and proactive in managing this critical network data. The alternative is member dissatisfaction and increased exposure to regulatory sanctions, potential lawsuits and member disenrollment.
PRIME: We specialize in validating your provider data
With this in mind, Atlas Systems developed PRIME Provider Data Validation Services. The PRIME service is designed to achieve the highest level of data accuracy while supporting any unique and specific needs of a health plan.
Provider Directory Benchmark:
An Assessment of Data Accuracy and Volatility
Snippet: The volatility of provider data (the rate at which provider demographic information changes) can range from 1% to 3% per month. This means that fully one third of the data published in a provider directory can be out-of-date and inaccurate within the course of one year, and that assumes the source data was 100% accurate to begin with. As the findings within will show, that assumption would be incorrect in essentially any instance.
This study focuses on the types of changes that cause a directory entry to be considered inaccurate from the perspective of a health plan member. Thus, we evaluated only the primary directory information necessary to select a health plan product or to contact a provider office to make an appointment.
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As a health plan, you want to deliver superior member satisfaction and eliminate audit risk, by keeping provider data updated. PRIME delivers superior data accuracy and the confidence that comes with knowing that your provider data is available, accurate and fully attested at the source.
Your provider directory - an asset
Provider directories and network data can be a competitive advantage or an invitation to audits, potential lawsuits and member dissatisfaction. Our recent health plan audits have shown that provider directories can average more than a 31% error rate among critical data fields.
With PRIME, you can be certain that your provider data is an asset. PRIME customers are achieving up to 98% data accuracy.
Provider data manager, Large US Health Plan
PRIME is the synthesis of sophisticated information technology and highly trained, specialized staff with expertise and experience conducting provider outreach. Because the only effective way to achieve the industry’s highest accuracy level is through direct, primary source data validation and attestation, PRIME contacts and surveys provider locations to collect and authenticate any and all key provider demographic data required by you.
Using the PRIME platform to manage efficiency and quality, Atlas Systems is capable of delivering superior accuracy and custom service to help you deliver the member experience that consumers have come to expect.