Validated Provider Profiles Helps Health Plans, Including CHRISTUS Health Plan, Meet Provider Data Compliance Mandates
Boston, MA – April 4, 2023 – HealthSparq, a Kyruus company, unveiled Validated Provider Profiles to help health plans meet federal and state provider data requirements and improve the accuracy of member-facing directories.
As many as half of provider directories have inaccurate data, causing health plans to face citations and fines. While data accuracy has been a focus for Medicare and Medicaid plans for years, with the No Surprises Act this extends to commercial plans as well. As of January 1, 2023, health plans must confirm or attest provider data every 90 days and ensure directory updates appear in the member experience within 48 hours. With Validated Provider Profiles, health plans can automate data collection and ongoing validation to improve care access for members.
In a recent survey of 200 health plan executives, improving provider data accuracy was the number one area of collaboration they reported would help most improve the member experience. Validated Provider Profiles builds on HealthSparq’s experience with health plan provider directories and Kyruus’ experience working with providers to deliver a streamlined attestation process that is seamlessly reflected within the member-facing online and print directories.
CHRISTUS Health, a Texas-based not-for-profit system of community hospitals, urgent care centers, health insurance companies and physician clinics, will leverage the combination of Validated Provider Profiles and HealthSparq One® member directory to reduce compliance risks and allow their members access to the most current and accurate provider data. “This solution solves one of our biggest challenges: that of a fragmented and manual workflow,” said Ron Hirasaki, Vice President of Product Management & Marketing Sales for CHRISTUS Health Plan. “We started our partnership with Kyruus through our health system. With the addition of HealthSparq, we are now uniquely positioned to strengthen both the insurance and delivery side of the business, ensuring a seamless, accurate patient experience at all points of entry.”
Kyruus President Paul Merrild said, “With Validated Provider Profiles, Healthsparq and Kyruus are not only helping health plans meet their compliance requirements, but also reducing friction and operational costs. From our years of working with both sides of the house—payers and providers—we understand the partnership between a health plan and its providers is essential in ensuring people find the care they need from the physician they prefer.”
The Validated Provider Profiles solution supports health plans and providers with a turnkey, automated process to validate provider data on a rolling 90-day basis. It offers health plans the ability to:
- Simultaneously meet provider data requirements for all lines of business by validating required fields within a single workflow
- Increase data accuracy with direct provider outreach
- Support providers by delivering a simplified validation experience
- Improve the member experience with automatic provider directory updates within a health plan’s HealthSparq One® member-facing transparency and guidance solution
To learn more about HealthSparq Validated Provider Profiles, click here.
About HealthSparq, a Kyruus company
HealthSparq helps people make smarter healthcare choices by partnering with health plans to share cost and quality information about doctors, hospitals, medical services, and medications. Serving more than 90 million members across the country and 100 health plan brands, our industry leading platform includes solutions for provider data accuracy, price transparency, provider search, rewards, and scheduling. Together with Kyruus, we’ve reimagined a better healthcare journey by connecting people to the right care, resulting in more satisfied members and patients, more aligned and engaged clinicians, and improved financial performance for the organizations we are proud to call our partners.
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