Addressing the increasing expectation on health plans to present patients with accurate directories of available health care professionals, the American Medical Association (AMA) and LexisNexis Risk Solutions are collaborating to offer a solution intended to maintain high-quality data for use in network directories.
The collaboration combines the data resources of the AMA, its wholly owned subsidiary AMA Business Solutions, and LexisNexis Health Care to provide a solution, LexisNexis VerifyHCP, to pre-fill, collect, monitor, cleanse, and update clinician data. The solution, which will be available by the end of 2016, is intended to create efficiencies for health insurers and clinicians that streamline the process of maintaining an accurate and up-to-date network directory.
Changes to clinician data naturally occur and erode the accuracy of network directories. Accurate directories are necessary for consumers to make informed decisions and enrollees to find suitable medical care. As federal and state agencies tighten regulations for providing patients with up-to-date and accurate lists of health care professionals, health plans face an evolving mix of rules and mandates. As a result, physician offices are burdened with an increase in repetitious data verification requests from health plans that are required to constantly ensure the quality of network directories.
“It has never been more important for both operational and compliance purposes to identify, validate and update clinician data in real-time,” Josh Schoeller, vice president, client engagement, LexisNexis Health Care, said. “Working in collaboration, the AMA and LexisNexis Health Care are offering a comprehensive and authoritative solution that delivers a flow of accurate data to meet state and federal directory mandates, and most importantly, supports the needs of patients, physicians and payers.”
“LexisNexis Health Care provides unique analytic technology and proven capabilities that complement the AMA's extensive data resources and supports the important goal of providing patients with accurate network directories,” Laurie McGraw, AMA senior vice president of health solutions, said in a statement. “Working together to solve a significant industry challenge will provide physicians a simplified alternative to updating practice information with multiple payers that reduces administrative burdens and workflow disruptions.”