Press Room

LexisNexis Risk Solutions Launches Provider Directory Accuracy Solution at AHIP Institute & Expo 2016

LexisNexis VerifyHCP to Assist Health Care Payers Meet State and Federal Provider Directory Requirements

6/14/2016

LAS VEGAS and ATLANTA – LexisNexis® Risk Solutions, a leading provider of data intelligence, analytics and technology, today announced at AHIP Institute & Expo the launch of LexisNexis VerifyHCP, a robust multi-faceted solution designed to help health care payers and providers ensure the accuracy of data published to consumers through directories. New Centers for Medicare and Medicaid Services (CMS) regulations allow insurers to be fined for errors in Medicare Advantage plan directories; several states are looking at instituting – or have already instituted – requirements to ensure the accuracy of provider directories. LexisNexis VerifyHCP enables health plans to meet both state and federal requirements and realize added value across the enterprise as a result of having the most up-to-date information on providers co-mingled with claims analytics and services. AHIP Institute & Expo 2016 attendees may learn more about LexisNexis VerifyHCP at the LexisNexis Health Care booth #551.    

“We are proud to be launching LexisNexis VerifyHCP at the AHIP Institute & Expo 2016. Our business is built on decades of experience managing provider identity information and because of this and our data stewardship we are confident our solution will go beyond regulatory requirements and drive value across the payer enterprise,” said Josh Schoeller, Vice President, Client Engagement, LexisNexis Health Care. “We are best positioned to help payers keep their directories current, tapping into information on more than 8 million health care professionals as well as facilities and more importantly leveraging smart analytics to conduct outreach and ongoing monitoring of the information being collected.”

LexisNexis VerifyHCP helps health care payers maintain their provider directories with the most current health care professional demographic information, as well other data elements like office hours, languages supported, whether the provider is accepting new patients, the provider’s Medicare participation status and whether the provider accepts Medicare and Medicaid patients. Key features of LexisNexis VerifyHCP include:

  • The LexisNexis Provider Data MasterFile, which incorporates more than 2,000 sources of data and covers more than 8.5 million providers, enabling the “best view of a provider”
  • A multi-channel outreach services component conducting campaigns including email, fax, call and direct mail
  • A payer consortium, which includes network, plan participation and contributed claims
  • A health care professional validation portal enabling streamlined provider self-attestation by physicians or designated staff
  • Ongoing monitoring of plan activity and tracking of claims data updates
  • Auditing through a standard platform to track when provider information was last verified to enable compliance reporting

“Provider data changes quickly, and the state and federal regulatory environment has spoken: provider directory accuracy is non-negotiable,” added Schoeller. “But, it has to be done right, and that’s where LexisNexis Health Care comes in. We have been the leader in Provider Data Management (PDM) for over a decade working with over 60 health plans including eight of the top 10, and these new requirements are a natural extension to our integrated offering. In order to really move beyond the tradition reactive state of PDM a solution needs to be multi-facetted leveraging deep data and analytic assets, and we look forward to helping payers and providers meet the challenge with confidence.”

To learn how quickly provider data changes, view an infographic titled, “Pitfalls of Health Care Provider Data.”

For updates on the launch throughout the event, follow @LexisHealthCare and join the discussion on twitter: #ProviderDirectoriesDoneRight

About LexisNexis Risk Solutions
LexisNexis Risk Solutions harnesses the power of data and advanced analytics to provide insights that help businesses and governmental entities reduce risk and improve decisions to benefit people around the globe. We provide data and technology solutions for a wide range of industries including insurance, financial services, healthcare and government. Headquartered in metro Atlanta, Georgia, we have offices throughout the world and are part of RELX Group (LSE: REL/NYSE: RELX), a global provider of information and analytics for professional and business customers across industries. For more information, please visit www.risk.lexisnexis.com and www.relx.com.

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