What You Should Know:
- 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.
Real-Time Provider Directory Updates to Help Payers Comply With NSA Requirements
Since the onset of the pandemic, there has been a noticeable trend towards decentralization in provider data updates. As a consequence, a significant 81% of the information entries in the five largest payer directories have proven to be inaccurate. While the issue of payers relying on outdated provider information has long had practical implications, the recent implementation of the No Surprises Act has introduced the possibility of substantial fines, intensifying the need for a resolution. This legislation now compels health plans to verify and revise provider information every 90 days, and it also mandates that payer databases must be updated within a strict 48-hour window upon 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.