Posts Tagged Provider Databases

EMR Systems and Provider Databases

Thursday, October 29th, 2015 | Permalink

As EMR implementation continues, there is increasing awareness of the lack of accuracy and utility of the Provider Databases that underlie new systems.  This reflects the heightened emphasis on accuracy required by HIPAA regulations in communicating patient PHI, but also the lack of resources available to provide quality external Provider information.

Typically the new EMR system allows either self or batch enrollment of the client’s internal and/or credentialed provider file. (more…)

Affordable Care Act (ACA), Nurse Practitioners, and Provider Databases

Monday, April 21st, 2014 | Permalink

The Affordable Care Act (ACA) has had an uneven beginning but appears to be gaining traction in expanding health insurance to uninsured Americans. The ACA will have an impact on Provider Databases as a result of increases in referrals and changes in referral patterns with new insurance networks.

One other ACA impact on Provider Databases results from the restrained growth in new physicians in the U.S. coupled with the increased retirement of the existing ‘boomer’ generation of physicians.

The demand/supply imbalance coupled with the desire to ameliorate the rise in healthcare costs will undoubtedly lead to greater use of ‘non physicians’ performing primary care services (more…)

Provider Databases: A National Problem

Monday, March 24th, 2014 | Permalink

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. (more…)

OBAMACARE and Legacy Provider Databases

Monday, January 6th, 2014 | Permalink

The implementation of Obamacare and the resulting increase in newly insured Americas will have important implications for legacy referring provider databases in healthcare organizations as they attempt to provide coordination of care.

This is a result of two factors: First, the newly insured population will, in most cases, have received some form of healthcare… (more…)


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