Register Now
Why register?
Login
 The leading web portal for pharmacy resources, news, education and careers March 21, 2019
Pharmacy Choice - Pharmaceutical News - CAQH Develops Artificial Intelligence to Improve Provider Directory Accuracy - March 21, 2019

Pharmacy News Article

 3/14/19 - CAQH Develops Artificial Intelligence to Improve Provider Directory Accuracy

WASHINGTON, March 14, 2019 /PRNewswire/ CAQH has developed patent-pending artificial intelligence (AI) technology to identify incorrect healthcare provider data and improve the accuracy of directories without contacting the provider. Health plans can use the findings to improve data quality and decide which office locations and other information about a provider to publish in their directories.

CAQH Logo (PRNewsfoto/CAQH)

While the healthcare industry has long grappled with provider data quality issues, beginning in 2016, the Centers for Medicare and Medicaid Services (CMS) began conducting annual reviews of Medicare Advantage online directories. Plans with high percentages of inaccurate directory data are subject to significant fines. CMS has determined that, in some cases, half of the information in directories may be inaccurate, with office locations being particularly problematic.

"Until today, the best method to verify information has been to make phone calls to the provider, but that option is costly and ineffective," said Atul Pathiyal, Senior Vice President, Product and Strategy at CAQH. "Applying our AI gives the industry a better, continuous way to address provider directory accuracy."

The CAQH AI technology draws on information entered by 1.4 million providers in CAQH ProView and integrates a wealth of data from other sources to train its AI model. Using machine learning, CAQH is continually improving the model's identification of good and bad data.

By avoiding individual provider outreach when verifying basic information, such as whether a provider sees patients at a given office location, health plans can improve directory accuracy while reducing provider abrasion. Based on data gathered to date, CAQH believes that health plans can save up to $91 million annually, just from reducing provider outreach costs across the industry. The total savings due to data improvements are likely much higher.

Improving provider data accuracy, completeness and timeliness is a focus for CAQH, and AI is one example of how the organization uses leading-edge technology to address industry-wide challenges. In the future, CAQH plans to apply more machine learning, advanced analytics and AI technology to score additional data elements that commonly challenge the industry.

About CAQH

CAQH is the leader in creating initiatives to streamline the business of healthcare. Through collaboration and innovation, CAQH accelerates the transformation of business processes, delivering value to providers, patients and health plans. Visitwww.caqh.organd follow us on Twitter:@caqh.

Cision View original content to download multimedia:http://www.prnewswire.com/news-releases/caqh-develops-artificial-intelligence-to-improve-provider-directory-accuracy-300812003.html

SOURCE CAQH




Pharmacy News Index
  Drug Delivery Systems
  Drugstores
  FDA Final Approvals
  Front Page Healthcare News
  Generic Drugs
  Hospital Industry
  Internet Pharmacy
  IT in Healthcare
  Medicare & Medicaid
  Over-the-Counter Drugs
  Pharm Industry Trends and Policy
  Pharmaceutical Development
  Pharmaceutical Industry

LIVE ONLINE CE

Last Chance
Mar 21: HIV Medications: Newer Drugs, Newer Guidelines
Last Chance
Mar 22: NSAIDs, Acetaminophen and Adjuvants in Pain Management
Mar 24: A Look Inside the Top 200 Drugs
Mar 25: Medication Use During Pregnancy & Lactation
Mar 26: Nutrigenomics - Nutritional Influences on the Genome
Click for entire Webinar Calendar

Special Announcement

Free Membership
Enjoy Drug Search, industry newsletters and more...

Nursing Jobs
Are you a nurse looking for a job?

Check out the Nursing Job Source.

Your number one choice for nursing jobs.



Websites » RxCareerCenter.comRxSchool.comClubStaffing.comNursingJobSource.comRN.com
Copyright © 2019 Pharmacy Choice - All rights reserved.
Terms and Conditions | Privacy Statement
888-682-4415