HealthDetail

Software DevelopmentGeorgia, United States2-10 Employees

Guidelines for maintaining the accuracy of provider directories for Medicaid managed care plans, Medicare Advantage plans and Marketplace plans are inconsistent between federal organizations and still evolving at the state level, leaving Accountable Care Organizations in an uncomfortable position and at risk for fines due to compliance violations. All parties agree that having readily available, accurate, up-to-date information is critical to providing health services to members, but the standard for maintaining that information and the best practice methodology for getting there are continually up for dispute.

HealthDetail’s long-established ProviderOne verification services can help maintain the accuracy of your provider directories, limit your exposure to complaint-generated audits and negate the risk of compulsory fines and expensive corrective action plans.

ProviderOne helps maintain your compliance with current CMS guidelines for monthly updates of printed directories and electronic directory updates within 30 calendar days (per 42 C.F.R. § 438.10) employing a broad range of services including address validation, phone verification, data validation, and NPI (National Provider Identifier) Updates.

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