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Provider Directory
The creation and maintenance of a provider directory for a health plan’s network is a continual process. For many health plans, this process is a very manual and paper-based set of independent activities. As the complexity of the health system continues to grow, so does the provider directory process.
With our extensive knowledge of managing provider information and building provider directories, Portico has designed our application to fully automate the creation and maintenance of provider directories. Providing this automated solution to health plans assists health plans in becoming more efficient as well as adhering to best practices by having an NCQA compliant directory. Portico’s Directory solution also increases the ease of doing business with the health plan from a provider and member perspective.
Key features:
- Workflow-driven data capture from multiple data sources (e.g. internal systems, online provider portal, external data sets, etc.)
- Data cleansing and enhancement through integration with leading external data providers
- Robust and flexible information model for directory data storage and maintenance
- Vanity listing support
- Dynamic creation of custom directories (network/product, employer specific, etc.)
- Rules-driven inclusion and exclusion of providers into directories
- Comprehensive audit tracking for directory changes
- Flexible directory extract files for 3rd party print vendors
- Intelligent online member tool for provider look-up and comparison
- Rules driven sorting of provider search results
- Integration with third-party geo-coding services for visual location display, distance calculation and driving directions
- Integration with existing style sheets to support branding initiatives
Key benefits:
- Increased provider directory accuracy
- Reduced cost of directory maintenance
- Increased member satisfaction and online adoption
- Increased speed to market of directories
- Reduced medical costs
