Healthcare industry leaders are continuing to invest in strategic initiatives that improve data quality, accuracy, and accessibility. However, healthcare providers can get more out of their MDM solution by integrating third-party data sources. NPPES integrations can prevent claim denials and increase revenue fulfillment by ensuring that all data is complete, accurate, and accessible. Claims denials are damaging to any healthcare company’s bottom line, but can be positively impacted by MDM and Data Quality best practices. By using provider information validated and enriched by NPPES, healthcare providers decrease the possibility of claim denials and increase billing efficiency in the medical billing process.
Implementing master data management (MDM) with CMS NPPES integration enables Healthcare Credentialing Offices to operate in an efficient manner. The goal is to standardize the master data across the entire organization so it is consistent, accurate, and accessible by all systems in “near” real time.
Integrating NPPES with your existing provider credentialing data in MDM ensures claim codes are up to date and enables proactive controls for correcting errors before submitting to insurance providers.
Data can be integrated, and therefore cleansed more quickly, even with changing semantics in disparate systems. This will reduce manual entry time and chance of error. Easily accessible data that is more accurate, and more consistent, improves approval rate in the adjudication step of the medical claim process.
An MDM solution integrated with NPPES allows for data processing to be streamlined. Data can be used for operational activities such as updating records, merging duplicate records, and throughout the medical claims process within the organization. Integrating MDM with NPPES will increase the value of the data as well as provide interoperability capabilities between systems.
MDM and NPPES offer a third-party authoritative data source. A single, trusted source of data will produce better compliance results and maximize revenue.
Contact us to know more about how our NPPES Connector will help your organization