eProvider – Provider Data Management Services

The Issue
For many large healthcare payers the administration and maintenance of tens of thousands of provider files poses a heavy administrative burden: identifying and deleting duplicate or outdated records; translating and standardizing information across organizations; maintaining accurate, current data; and eliminating redundancy are just a few of the challenges payers face in managing their provider data.

The Solution
Viant’s eProvider - Provider Data Management Services is an automated solution that ensures the accuracy of provider files using sophisticated provider matching logic based on a number of unique data elements. The result is optimal provider records that enable payers to make more accurate and timely payments without administrative headaches.

Value Points

• Eliminate duplicate provider records - eProvider matching logic cross-checks and maps diverse provider information submitted by multiple networks to deliver a single provider record within the Viant system
• Maintain complete provider demographic and network relationship information
• Ensure accuracy in production of provider directories
• Ensure that the correct payment rates are utilized when a claim is received
• Realize significant administrative cost reductions

How it Works
Provider records are pre-loaded into Viant’s eProvider system, which uses numerous unique data elements to ensure an accurate provider match. If the name on the billing statement has a different spelling from or is an abbreviated form of the official provider record in our system, an alias using the name on the billing statement is built into that record to ensure the accuracy of future record matching. With frequent updates being loaded into the system, Viant’s database contains the most accurate, up-to-date provider records, which payers can use to update and amend their provider directories.

Advantages

• 97% of provider data is auto-loaded, with less room for human error
• More than 99% accuracy of in-network matches
• More than 1.4 million unique provider records currently loaded in the eProvider system
• The eProvider database stores an unlimited number of external system identifiers, multiple contractual arrangements, HIPAA identifiers, board certification, degrees, office hour information, etc. in each record
• Provider directory information can be transmitted from one source, in one format, to the point(s) of production
• Provider data can be returned to client’s legacy systems to simplify data management and reduce future duplication

Summary
Payers need to assemble a system of PPO or HMO networks to compete aggressively. But the costs, complexity and administrative burden of managing thousands of provider files can quickly outstrip the competitive gains. Viant’s eProvider - Provider Data Management Services employs sophisticated matching logic and technology to harness the most up-to-date provider information available, maximizing for our clients the quality, efficiency and usability of provider data, while reducing administrative costs.

To learn more about Viant’s eProvider - Provider Data Management Services, call us today at 800.820.5824.