Resource Library

Insight and advice from the experts.

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Research Reports

Provider Network Integrity: A Data Intelligence Report

Provider directories matter because members rely on them. When a health plan member searches for an in-network doctor, they’re trusting that the listing is current, […]

Research Reports

The Dynamics of Provider Eligibility Data Management

How healthcare executives manage provider eligibility data — and what needs to change. Provider eligibility data serves a critical role across the administrative and operational […]

Events

Published, Not Perfect: What’s Lurking in Your Provider Directory?

Health plans are legally required to publish their provider networks via a FHIR-based API — a public statement of who is credentialed, in good standing, […]

Blog

What 150 Healthcare Executives Really Think About Provider Eligibility Data

Provider eligibility data touches nearly every corner of a healthcare organization. It underpins some of the most consequential decisions an organization makes — from hiring […]

Blog

A Race Against Time: Why Timely MFCU Reporting Is Vital to Medicaid Program Integrity

Do you have the resources; time and or people? Do you have the expertise? Do you have an internal audit team or are you using contract auditors?

How often should you audit? What do you do with the audit findings? I am tired already, and we haven’t even gotten started.

*Updated from original post on 11/15/2016

SFTP vs API : Which Integration Method Is Best? Featured Image

Blog

The Credentialing Data Gap: Why Payer Teams Are Still Chasing Data Manually

Do you have the resources; time and or people? Do you have the expertise? Do you have an internal audit team or are you using contract auditors?

How often should you audit? What do you do with the audit findings? I am tired already, and we haven’t even gotten started.

*Updated from original post on 11/15/2016

Events

The Verification Layer: Provider Data for the AI Era

Learn how ProviderTrust solves credentialing challenges with its automated, ongoing credential and license verification solution.

Research Reports

What Is Data Enrichment? Behind the Scenes of ProviderTrust’s Exclusion Monitoring Strategy

Learn why payers’ provider data isn’t as “clean, complete, and centralized” as leaders claim.

Blog

7 Reasons to Retire Daily License Verification

The truth is that daily verification just doesn’t move the needle as much as some of our competitors claim. It’s time to retire the idea of daily verification as the answer to the complex problem of license verification, and we’re here to explain why.