The New Era of Electronic Provider Data (Recorded Webinar)

Date: Thursday, November 19, 2015
Time: 2:00 – 3:00 pm ET (1:00 – 2:00 pm CT)

Speaker: Sorin Davis, Managing Director, CAQH

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The healthcare industry has redundant, inefficient data gathering processes. Provider credentialing places an enormous burden on medical staff personnel who spend hours completing multiple, duplicative forms. As the movement from pay-for-service to pay-for-value payment models gains popularity, more non-traditional types of healthcare providers – including social workers, behavioral health specialists and even fitness trainers – must be credentialed as they become part of the healthcare system and increase the credentialing workload.

Along with new reimbursement models, population health management requires the need for more granular provider data that can be used for credentialing and also for provider directories in order for the medical record to accurately follow the patient through all points of care.

No single organization or company currently captures, maintains, or integrates all of the data that providers are asked to continuously supply, and that health plans, third party administrators, hospitals, labs, pharmacies, and others use on a daily basis.

Some experts believe a national database is a logical solution to solve the growing problem of the need for a single source of truth for provider data. While nearly all stakeholders acknowledge the need to improve the collection, maintenance and distribution of provider data, streamlining and improving these processes will not be easy.

What does the ultimate provider database in the era of the ACA and healthcare reform look like? In this session, attendees will discover how a fully electronic solution that enables the collection of a more robust provider data set could save time during the credentialing process and also be used for much more. A reliable and complete source of provider data could also increase claims adjudication accuracy to speed reimbursement and help to improve overall healthcare quality as new payment models require analysis of aggregated clinical, claims and administrative data.

What You Will Learn:

At the end of these presentations, participants will be able to:

  • Name the challenges of collecting vast amounts of provider data and how that impacts its use for credentialing and other purposes.
  • List the benefits of using an online solution vs. traditional methods to capture administrative data to create a single source of truth for a robust provider data repository.
  • Recognize how healthcare reform, including the Affordable Care Act, is impacting the need for more types and use of administrative provider data beyond credentialing.

Speaker Bio:

Sorin Davis is a Managing Director at CAQH.  A non-profit alliance, CAQH is the leader in creating shared initiatives to streamline the business of healthcare. With more than 35 years of experience in health insurance, healthcare management, benefits administration, sales and marketing, Sorin has served the healthcare industry from many perspectives.  During his tenure with CAQH, he was responsible for the national launch of the CAQH Universal Provider Datasource initiative, now CAQH ProView. Previously, Sorin was executive vice president of MultiPlan, and CEO of its subsidiary, CareAway USA. He was director of labor sales and account management at Empire Blue Cross, and director of claims administration for the Amalgamated Life Insurance Company. Sorin holds a master’s degree in public administration from New York University, specializing in health services management.

Who Should Attend:

Medical services professionals, credentialing professionals, and credentials committee members interested in will discovering how a fully electronic solution that enables the collection of a more robust provider data set could save time during the credentialing process .

Cost: 

NAMSS Members: $55
Non-Members: $75
Group Purchase: $150 (Provides access to the webinar and five (5) individual CE certificates)
Additional CEs (beyond 5): $85 per 10 additional certificates. Purchase as many packs of 10 as you need.

CE Credits:

This webinar has been approved for 1.0 CE Credits.