As a payer organization, how many health systems and provider practices regularly send you provider directory rosters?

Health plans at Madaket report that approximately 90% of provider updates come from sporadic ad hoc reports, which means that of 1,000 provider updates, about 900 require payer organizations to review for accuracy and reporting. Unsurprisingly, manual updates are both time-consuming and leave room for error. So, without an efficient, automatic way to consume data from third-party sources, payer organizations are faced with wasting significant resources.

Watch the latest Madaket Minute to learn more about the challenges of keeping up with provider directory updates.

Read the video transcript below and subscribe to Madaket Health on YouTube.

Video Transcript:

Hello, health plan administrators. Today, on this Madaket Minute, Chunky and I are helping you peel back the curtain on the complex task of provider roster ingestion.

The inability to efficiently consume data from third-party sources, such as individual physician updates in your network, is a common strain on your operations. From various formats like emails, faxes—even napkins— the challenges are real. But what if there were a way to absorb information in any format and map it seamlessly into your system? Let’s break this down.

How many of our large health systems and smaller provider practices send you rosters on a regular basis? Usually, the only regular rosters are coming from large health systems, while the smaller practices—you might call them the little guys—send their updates via ad hoc reports. You know this all too well. Not many provider groups fall between these two gaps. Most health plans tell us, at Madaket, that somewhere around 90% of their provider updates come from ad hoc reports that have to be manually scrubbed for accuracy. That’s a lot of work.

They tell us that only a fraction of their total providers, maybe 10%, send their updates on a clean roster every month. That means that, let’s say out of 1,000 provider contracts, about 900 of those would be ad hoc reports to manually review for accuracy and reporting before they get input into their database.

The problem is that the large provider groups are going to send this data in whatever format they see fit, naturally, which makes you have to reorganize the data before you take it in. We’ll talk about how to fix this problem on the next Madaket Minute.

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