Madaket’s software will help HPS maintain compliance and improve NPS scores for its 27,000 providers.
CAMBRIDGE, Mass. – Nov. 7, 2023 – Health Payment Systems (HPS) today announced it has selected Madaket Health to help manage its provider directory and roster requirements for No Surprises Act (NSA) compliance. HPS, which supports 27,000 providers across 96 hospitals, selected Madaket’s Provider Data Exchange thanks to its innovative approach to data verification, ease of use and automated update model. Madaket will ingest the HPS provider rosters, validate the provider information, identify and fill provider gaps and send HPS a daily provider directory feed to support both their internal systems and their searchable member directory,
Since the start of the pandemic, provider data updates have become further decentralized, resulting in 81% of entries in the 5 largest payer directories being inaccurate. Though there have long been practical consequences to payers carrying outdated provider information, the recent enforcement of the No Surprises Act has added the potential for hefty fines, increasing the urgency for a solution. The legislation requires health plans to verify and update provider information every 90 days, and mandates that payer databases be updated within 48 hours of receiving updated provider information.
“After examining a number of solution providers, we came to the conclusion that none could match the seamlessness and accuracy of Madaket’s Provider Data Exchange. Madaket gathers data from a wide range of sources and has an extremely thorough standardization and verification process that makes the information truly drag-and-drop,” said Brian Marsella, President of HPS. “Madaket’s software will help us avoid compliance penalties, improve NPS scores with members and providers and enhance our member experience.”
Madaket’s Provider Data Exchange (PDX) offers real-time provider directory updates, combining the power of its provider data management (PDM) platform with its provider directory of over 80% of providers to help payers effortlessly comply with the No Surprises Act’s 48-hour requirement. The information exchange platform verifies and updates data in all necessary places, allowing administrators to focus their attention on other essential tasks and trust that they remain compliant with all regulatory requirements.
“We’re thrilled to be able to support HPS across their administrative hurdles to allow them to put their bandwidth where it is needed: Delivering positive member outcomes. The healthcare industry is littered with manual inefficiencies, and if our products can help to automate those challenges, payers, providers and patients will all benefit,” said Madaket CEO Eric Demers.
The provider data exchange helps payers streamline their operations through:
- Automated payer roster ingestion and maintenance
- Automated inbound provider updates
- Group-specific, multi-step data verification processes to ensure accurate information
- Realtime payer reports for transparency and verification
- Flexible, scheduled data delivery that powers payer systems
Madaket’s provider data exchange is broadly available to payers across the healthcare industry. Organizations looking to take control of their provider data can schedule a five minute call to learn how Madaket can help improve member satisfaction at https://www.madakethealth.com/schedule-a-demo
About Madaket Health
Madaket Health accelerates healthcare administration with seamless integrations and a fully connected platform that ensures healthcare organizations run smarter, faster, and more efficiently. With Madaket, providers, payers, and intermediaries uncover provider data analytics and insights, saving more than $600 million in the process. The company’s platform automates 90% of burdensome and error-prone administrative tasks, streamlining provider credentialing, licensing, and verification processes, boosting staff productivity 10-20X while reducing processing times by up to 50%. Learn how Madaket targets billions of dollars in healthcare administrative waste by simplifying provider data management, revenue cycle, and exchange processes at madakethealth.com.
About Health Payment Systems, Inc.
Health Payment Systems (HPS) is a privately held PPO network in the state of Wisconsin. HPS is the parent company to PayMedix, an EOB consolidation tool known as the SuperEOB that serves all contracted providers and enrolled members. The PayMedix single-statement billing helps families combat confusing and unaffordable medical bills, while its guaranteed payment model eliminates provider collection costs and risk. HPS is headquartered in Milwaukee, Wisconsin. To learn more, visit Health Payment Systems.