# 5 BEST PRACTICES

# IMPROVING PROVIDER DATA ACCURACY, PROVIDER OUTREACH AND OUTCOMES

**Everyone’s buzzing about improving provider data accuracy and transparency these days—and for good reason. Just**  
**like an athlete training to reach peak performance, healthcare professionals like yourself need the right strategy**  
**and tools to succeed. In this article, we’ll dive into five best practices for improving provider data accuracy and**  
**outreach to achieve better outcomes.**

## BEST PRACTICE 1: BE INTENTIONAL WITH YOUR OUTREACH

When it comes to provider outreach, not all methods are  
equally effective. Incorporate these three strategies to  
improve the success rates of your outreach efforts.

## PROVIDER AT LOCATION

One of the most prevalent errors in provider directories  
is listing providers at the wrong location. To avoid this  
problem, perform what’s called location-centric outreach.  
Rather than reaching out to individual providers and  
asking them to confirm their various practice locations, the  
location-centric approach is focused on confirming the  
status of all providers at a specific location. It’s like targeted  
outreach but for provider locations.

## MULTIPLE COMMUNICATION CHANNELS

As you enhance your outreach methods, don’t just stick to  
one communication channel. There are plenty of options  
available, and we recommend using them all. Reach out to  
providers through various channels like email, fax, direct  
mail, and phone. The more avenues you explore, the  
greater your chances of getting the necessary updates.

## TAILOR TO SMALL AND LARGE GROUPS

Provider outreach is not a one-size-fits-all endeavor. Large  
groups and health systems typically have more providers to  
confirm compared to individual and small group practices.  
You’ll want to customize your approach and adjust your call  
to action accordingly to maximize response rates and make  
everyone’s lives easier.

## BEST PRACTICE 2: PRIORITIZE YOUR PROVIDER DATA UPDATES

Establish priorities and processes to identify and correct  
the most urgent, sensitive, and high-risk areas that could  
potentially cause member dissatisfaction or compromise  
the integrity of your network. Consider these factors when  
determining your priorities and processes.

## HIGH-RISK DATA ELEMENTS

**•** Provider at Location Status  
**•** Provider Status  
**•** Provider Office Location Status

## HIGH DEMAND SPECIALTY

**•** Primary Care  
**•** Psychiatry  
**•** Obstetrics and Gynecology

## HEALTH EQUITY ELEMENTS

**•** Provider Linguistic Capability  
**•** Cultural Competency Training  
**•** Patient Populations Served

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## BEST PRACTICE 3: AUTOMATE YOUR DATA INTEGRATION

Manual sorting of massive amounts of data can cause  
delays and lead to outdated information. Automation tools  
such as an application programming interface (API) allow  
you to quickly integrate the information you receive from  
providers into your system.

## API INTEGRATION: STREAMLINING PROVIDER UPDATES

APIs open doors to seamless updates and enhancements,  
making life easier for your I.T. team.  While ensuring that  
you won’t be locked out of new data and giving you the  
ability to effortlessly find and analyze the specific data you  
need, exactly when you need it.

## BUILD UPON YOUR EXISTING INVESTMENTS

API integration builds upon your existing investments,  
so you don’t have to throw away all that hard work  
you’ve already done. Smart investments are the key to  
moving forward.

## BEST PRACTICE 4: BE TRANSPARENT

## ABOUT OUTREACH EFFORTS AND METRICS

Transparency is paramount in any provider data verification  
strategy. It benefits executives and internal stakeholders  
while keeping you compliant with regulations like the No  
Surprises Act. Demonstrate your efforts to both parties by  
incorporating these two types of analytics.

## SUMMARY METRICS

Get an overview of your network, highlighting unresponsive  
providers and essential information at the provider, service  
location, and provider at service location levels.

## DETAILED METRICS

Information about specific providers and facilities,  
such as the last time they received an outreach, the  
communication channel used, and whether the provider or  
facility  responded.

## BEST PRACTICE 5: USE A ONE-TO-MANY APPROACH TO REDUCE PROVIDER ABRASION

Providers and administrative staff are constantly fielding  
calls and emails regarding provider verification. As Steve  
Slaton highlighted in the Quest Analytics® webinar,  
“Facing the Realities of Provider Data Challenges to  
Improve Outcomes,” this constant outreach for updating  
information creates a tremendous burden on the health  
plan and provider community and can lead to provider  
abrasion. Here’s what you can do to minimize frustration  
and streamline the process.

## ONE-TO-MANY OUTREACH

Let providers update their information once and have  
that update disseminated to numerous organizations.  
Streamline the process, minimize frustration, and save  
time for everyone involved. It’s a win-win!

## INCENTIVIZE QUICK RESPONSES

Show providers how efficient and hassle-free the process  
is. When they see the benefits, they’ll be motivated to  
respond promptly, keeping your data accurate and up to  
date. One and done.

There you have it, the inside scoop on five best practices  
to improve your provider data accuracy. By implementing  
these strategies, you’ll build trust with your health plan  
members, stay on top of regulatory requirements, and save  
yourself time and effort.

## DRIVE EFFICIENCY, DRIVE RESULTS

**Looking to simplify your provider data outreach**  
**and accuracy efforts?** Let Quest Analytics® take the  
reins. Our solutions and dedicated team specialize  
in provider data accuracy and network adequacy,  
no matter the line of business. <u>Schedule a strategy</u>  
<u>session today</u> **to discover how we can help you**  
**every step of the way.**
