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The Problem:
Provider Networks are a compilation of both large and small groups of health care providers that are constantly changing. Many of these providers are in turn contracted through other organizations such as Independent Physician Organizations, Medical Service Organizations, and Physician Hospital organizations.
The average professional provider belongs to 2.7 contracting provider organizations. When an individual provider changes their practice location or group affiliation, the information may not percolate to the Network Manager for months. When the information does arrive, there may be confusion as to which group contracting entities are affected.
If the provider simply moved to another group that is contracted with your network, then the location change is important to make in the “system”. This is internal disruption.If the provider has changed group affiliations where the new Group does not have a contract with your network, then it is more imperative that the change be made to your system.
Solution:
Peregrine Management Corporation’s master data set is constantly updated and compared to your network in a way that provides clear and functional information about how providers are moving within your community of providers.
- RODES File: Lists who cannot possibly be in your network because they have Retired, moved Out of State, are Deceased, or have an Expired license.
- RODES Plus: Compiles address and practice location changes as providers move from location to location
- Group Monitor: Monitors activity within the Groups that you have contracted with. Know which new providers have joined the group and which have left.
- Timely Alerts: Receive e-mails of changes as we discover them they apply then to your network.
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