It’s a headache for health plans to update provider directories within the strict confines of the No Surprises Act (NSA). Thankfully, Madaket’s Provider Data Exchange (PDX) Platform alleviates the stress of navigating NSA compliance.
Our innovative, turnkey solution automates provider roster ingestion, contract management, and follow-ups with healthcare organizations to enable health plans to scale their directories and maintain NSA compliance without adding to their bottom line.
Watch the latest Madaket Minute to learn more about how Madaket PDX can help reduce your organization’s administrative burden.
Read the video transcript below and subscribe to Madaket Health on YouTube.
Video Transcript:
Hello, and welcome to another Madaket Minute. In our last Minute, we talked about the headache of trying to ingest provider rosters. As you know, the No Surprises Act requires health plans to update their directories within 48 hours of receiving provider updates. That’s not a lot of time. At Madaket, we’ve already solved this problem.
So, let’s say a health plan is using our provider data exchange tool, and we receive a provider roster. We at Madaket crosswalk that data to our internal system so that the health plan’s admin team doesn’t have to change the data before we take it in. Even if the roster data is reordered from time to time, like it is a lot of the time, our ingestion allows for flexibility of the data.
As an organization, you’ve likely already consumed the low-hanging fruit in this area. And in order to get your process to a level where it operates very well, it takes a substantial amount more investment. Now, as part of NSA, you have all these contracts with all these providers that you’re supposed to be touching every 90 days. How are you supposed to scale these touch points in a way that you know this information is as accurate as possible?
With our attestation process, our system looks at every contract—type one and type two NPIs—and sees which provider has hit the 75-day mark to reach out to the provider. This provider data curation can be used wherever else you need it, whether it be claims, adjudication, or whatnot. We have a follow-up process for small physician practices to large health systems if they’re ignoring our messages. We’re always tracking: ‘How is this performing systematically?’ as part of our ongoing fine-tuning.
On our next Madaket Minute, we’ll talk about the potential ROI of accurately curating your provider data to meet NSA directory guidelines. See you next time.
