Provider Databases: A National Problem

Much of the improvement in health care and efficiency rests on the foundation of accurate and up-to-date Provider information for efficient and error free billing, medical records and transcription…and even more importantly on long term patient ‘Continuity of Care’.

The emphasis on accurate Provider information has exposed weaknesses: a 2013 OIG report* found that 48% of Medicaid’s NPPES provider databases contain errors; California was forced to remove its Physician Directories from its state run Health Information Exchange (HIE) because of inaccuracies; and recently the ONC sponsored HIE Provider Directory Workgroup disbanded without any serious, feasible recommendations for implementation.

The inherent flaw in maintaining Provider databases (either centralized or federated) is the lack of incentives to healthcare institutions and Providers to maintain data coupled with an even greater underestimation of the cost of maintenance.

FolioMed has spent over 30 years maintaining census Provider databases by pooling disparate electronic records, applying a combination of software algorithms and tools, and combining all of this with systematic, proactive direct verification and analysis. Because of its high data accuracy and interactive, real time processing capabilities, FolioMed data has become a standard for many healthcare institutions and state agencies for data licensing and Provider database maintenance. In addition, FolioMed’s Cloud based Provider databases give instant and continual access to real time information based on FolioMed’s advanced relational databases.

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September 2020
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