How it Works
Data validation workﬂows allow for accurate and continuous updates to provider data, clinical scope of practice, locations, accepted insurance / network plans, and extensive practice details. Data requirements are tailored to both CMS and state provider directory regulations.
Multiple built-in workflows enable directory validation and corrections to be performed directly by providers or delegated to more appropriate office staff. You’ll always know when and by whom a provider’s directory proﬁle was last reviewed, validated, and updated. A hierarchal governance process allows role-based privileges to apply when data updates are requested, reviewed, and approved.
Automated Validation Reminders
During service initiation and continuously thereafter, provider directory management workﬂows allow quick data updates. Reminder emails and optional phone messages can be used to augment when providers and practices are unresponsive.
Our Unique Benefits - Directory Management
Built-in-GovernanceGranular security permissions provide both role and user based access. History and logging add accountability and provider data lineage.
In-line Data UpdatesEliminate faxes, phone calls, and paper mailings by creating an electronic directory validation workﬂow.
Single Source of Truth ReconciliationNo matter where your provider data lives today – operating, credentialing, marketing - MDﬁt consolidates it all into one easily managed area to be easily validated and updated.
Data Validation WorkflowsStamp of approval and reminders support having always-valid provider proﬁle and directory data.
Intergrated & Bi-Directional ApproachChanges propagate across the MDfit platform and to ancillary systems in unison.
Information AccuracyChange request workflows enable accurate and validated provider demographics, contact details, locations, clinical scope of practice, insurance, practice details, and many more.
Provider Directory Listing Requirements
This Provider Directory Listing Requirements document is a summary of CMS, Medicaid, Medicare, and CHIP provider directory requirements based upon our review. Also included are several recent state regulations, the NAIC model act, and the NCQA proposed 2016 accreditation standards for directories. Many of these rules and standards undergo frequent updates. Don't see your state or regulation listed? Contact us below for your customized directory requirements report.View PDF