Excellence in Provider Data Management

Manage the dynamic world of provider information

Excellence in Provider Data Management

Manage the dynamic world of provider information

Provider Directories In the News

Provider directory inaccuracies in many health plans have attracted the attention of regulators and consumer groups. However, provider directory inaccuracies are merely a visible symptom of a much broader challenge facing health plans as they attempt to manage the dynamic landscape of provider information.

The Sanator Solution

Collaborative Provider Data Management

Health plans typically have different systems which support providers across multiple business units and shared services – including networks, contracting, payment strategies, provider relations, directories and provider communications. Health plans gather provider data in many different ways that creates conflicting results, duplicated effort and unnecessary overhead that contributes to provider abrasion, consumer frustration and regulatory pressure.

 

In order for health plans to achieve high quality and timely provider data, without alienating their contracted providers, it is imperative that plans adopt a more collaborative approach to data collection and integration.

 

The Sanator Provider Registry is a collaborative data management platform leveraged by major provider organizations and health plans to reduce the administrative burden of provider data maintenance, data verification and alignment with operational processes.

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Excellence in Provider Data Management

  • Improved provider experience

  • Directory accuracy and consumer satisfaction

  • Regulatory compliance

  • Improved data quality and reduced administration costs

  • Insulation from evolving state and federal standards

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High Performing Networks

High quality provider networks are the lifeblood of a successful health plan. Progressive plans are looking for ways to improve the overall provider experience to attract and retain the best doctors, groups and facilities.

Sanator offers a provider network management (PNM) capability that enables health plans to understand many provider behaviors and characteristics that extend beyond their traditional profile.

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Excellence in Provider Data Management

  • Improved provider experience
  • Directory accuracy and consumer satisfaction
  • Regulatory compliance
  • Improved data quality and reduced administration costs
  • Insulation from evolving state and federal standards
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High Performing Networks

High quality provider networks are the lifeblood of a successful health plan. Progressive plans are looking for ways to improve the overall provider experience to attract and retain the best doctors, groups and facilities.

 

Sanator offers a provider network management (PNM) capability that enables health plans to understand many provider behaviors and characteristics that extend beyond their traditional profile.

The Sanator Journey

Sanator offers a graduated path to health plans wanting to start small and grow into a complete solution.

Sanator Journey 6

Connect

Roster Exchange

  • Transform multiple inbound roster formats into proprietary health plan format and preferred reference lists
  • Cleanse locations to USPS standards and apply geocoding
  • Validate state license number, NPI and CMS Facility certification number
  • Research inconsistent identifiers and issue notifications of corrections to the health plan and the submitter
  • Produce roster difference reports to the health plan in health plan's specific format to make it clear what has changed since the last roster
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Communicate

Attest to Health Plan Data

  • Leverage the Sanator Attestation module to simplify Medicaid, Medicare Advantage and commercial plan attestation for the health plan and its contracted groups
  • Attestation processing reduces administration and improves quality for all parties
  • Outreach to unresponsive groups with full audit trail
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Collaborate

Link to the Sanator Registry

  • Link health plan Private Instance to the Sanator Provider Registry to align health plan provider data with the provider data of hundreds of participating provider organizations
  • Validate provider data in a collaborative model with confidence and compliance scoring
  • Groups that participate in the Registry may now eliminate rosters completely and exchange provider updates with the health plan on a daily basis (in a health plan specific format)
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Optimize

Provider Network Management

  • The health plan may leverage the system-wide view of providers to provide additional insight into provider utilization and commitments across groups and plans
  • Sanator is collecting Provider MACRA measures and measuring a number of aspects of provider behaviors (location stability, plan loyalty, geographic spread etc.) to help plans and groups design more focused networks
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Sanator has the support of large provider organizations and is exclusively  endorsed and recommended by CAPG, the nation's largest trade association for provider organizations. Sanator clients are strong advocates for the adoption of Sanator by health plans and continue to promote the use of the platform to their contracted partners.

"CAPG and its member organizations strongly advocate the use of Sanator by contracted provider groups and health plans to reduce the burden on doctors and administrators."

William Barcellona, Sr. VP for Government Affairs

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Sanator has the support of large provider organizations and is exclusively  endorsed and recommended by CAPG, the nation's largest trade association for provider organizations. Sanator clients are strong advocates for the adoption of Sanator by health plans and continue to promote the use of the platform to their contracted partners.

"CAPG and its member organizations strongly advocate the use of Sanator by contracted provider groups and health plans to reduce the burden on doctors and administrators."

William Barcellona, Sr. VP for Government Affairs

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