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Information Exchange

McKesson Health Solutions’ Information Exchange solution enables health plans to utilize third-party provider information sources to increase provider information quality and breadth, while reducing administration costs. This application enables the importing, impact analysis and assimilation of external provider data into MHS’s repository. It has pre-built information brokers for CAQH’s UPD and Sanctions Track Report, ABMS, NPDB and NTIS. Additionally, it can be configured to support reconciliation from other external data sources, including business partners, network vendors, CVOs and other provider data vendors.

Business Challenges:

• Cost effective integration of external provider data sources
• Reconciliation of changes across multiple provider sources
• Credentialing SLAs negatively impacted by non-automated PSV process

Key Features:

• Automated trading partner data importing, impact analysis and assimilation
• Pre-built integration with CAQH’s Sanctions Track report for ongoing sanctions monitoring
• Extensive configurability enables client specific reconciliation of data sources (e.g., CVOs)
• CAQH Roster Wizard support for practitioners already participating with CAQH UPD
• Pre-built integration with ABMS Direct Connect for primary source verification of board certifications
• Batch interface configuration of data transformation rules, data quality validation, and thresholds
• Pre-built integration with NPDB for primary source verification of provider malpractice information
• Pre-built integration with NTIS DEA service for primary source verification of practitioner DEA license number

Key Benefits:

• Reduces the administration cost for data reconciliation across multiple 3rd party provider sources
• Supports improved credentialing decision-making through automated PSV
• Enables increased service excellence by reducing provider administration burden