A better way to capture provider information
Provider Data Management (PDM) offers an easy-to-use way for your providers to update, validate, and attest to the accuracy of their information. Why is it easy? Because they can do all these things on the same portal they use to check patients’ eligibility, submit claims, and receive ERAs.
Providers receive regular notifications right in their workflows reminding them of deadlines to verify their directory information. Machine learning and artificial intelligence identify providers whose information is likely to be incorrect or out-of-date; when there’s a mismatch between information the provider is submitting and what the health plan has on file, PDM sends a notification prompting the provider to update the record. This information can then be sent to each of the provider’s contracted health plans, ensuring every stakeholder has the most current information.
What sets Availity PDM apart
- Multi-payer platform allows providers to make updates once and have that information sent to all participating health plans.
- Availity intelligent gateway monitors billions of healthcare transactions to identify data anomalies between what the provider submits and what the health plan has on file.
- Provider data updates are sent to each participating health plan in the format and structure that health plan needs.
- Provider education gives providers information about patient quality and risk adjustment processes.