A Single Source of Truth: The Line in the Sand for Healthcare Systems and Payers

Many people assume significant changes to systems or processes take months, require major overhauls, and involve onerous work to get stakeholder buy-in. This can be true, but sometimes it just takes one person, system, or group to simply draw a line in the sand and say, “This is going to be different. We’re setting a new standard.”

We’re here to do that: Set a new standard when it comes to provider data management.

Certify recently hosted various healthcare leaders at Blueprint, a first-of-its-kind summit in New Orleans focused on topics like the administrative burden that healthcare systems face, data integrity, and the variables contributing to rising healthcare costs. In the coming weeks, on this blog, we plan to share some of what we learned and jumpstart conversations about creating a better, more efficient healthcare system.

In one session, Certify CEO Anshul Rathi led a panel with industry thought leaders Daryl Tol, the leader of General Catalyst’s Health Assurance Ecosystem, and Sarah Ahmad, the CEO of CAQH. The three leaders shared their insights into the provider data system and then discussed how healthcare systems and payers can collaborate to drive meaningful changes in provider data management.

The Challenges of the Current Environment

During this session, the panel shared some frightening stats:

• 52% of data directories have at least one error.
• Providers (or their admin teams) must fill out the same data 18 or more times.
• Dated processes have admin teams transcribing faxes into a digital format.
• One panelist even shared that health care systems could save over $75 million annually by streamlining provider data management.

Anshul explained that provider data is like a “middle child.” It sits at the center of every part of healthcare and bridges gaps between payers and healthcare systems, yet it always seems to be pushed to the side and forgotten. That is, until that “middle child” acts up and wreaks all sorts of havoc — missed deadlines, incorrect information, outdated addresses, and other errors that can cost providers millions of dollars and hours of time. On top of the administrative burden, when this happens, patients lose access to the providers they need, leading to deteriorating health outcomes.

To put it simply, Anshul explained that there are hidden pieces in healthcare administration that are the nuts and bolts of the infrastructure, but that simply aren’t working for providers, systems, or payers. These broken systems are part of the standard procedure, so people keep using them, doing the same things, regardless of how ineffective or unproductive they are.

For example, there is an ongoing process of healthcare providers filling out provider data forms for insurers.

Sarah explained that CAHQ has done the math: They found that it takes approximately 100 minutes for a provider to input the 130 data fields required on most forms. That adds up to $41 per provider, per form. Then, each provider inputs that data into an average of 18 network systems. That means that on average, the administrative burden for each healthcare provider to manage data is approximately 30 hours and $738. What’s worse: Upon submission, they aren’t done. That data needs to be updated regularly, meaning the expenditure is ongoing.

If you take those 30 hours and $738 times every provider in any health system and extrapolate it to consider the thousands of providers in each system, and hundreds of changes that happen each month, you’re left with a messy, burdensome, and expensive system.

In addition, many hours spent on provider data management are unproductive at best. For example, we told you earlier that some administrative teams are responsible for taking faxed data sheets from providers and transcribing them. Other processes require providers to take screenshots of their data before sending it, requiring an extra step that only serves to undigitize already-digitized material.

It would be laughable if it weren’t such a time-consuming and costly endeavor for all involved.

It’s easy to see why many providers and administrators have become fatalistic. The system is so daunting and complex that no one feels empowered to push the boundaries or to demand change.

We are ready to do so.

It’s time for us to draw that line in the sand.

We believe it’s time to set a new data management standard — one single source of truth and a high-tech infrastructure that relieves the administrative burden for both payers and systems.

The Opportunity to Create a Better System

During the session, Daryl said, “In this space, there isn’t even an architect, let alone a blueprint.”

At this moment, it’s clear that the provider data management system is broken. For years—decades, even — the system has been complex and time-consuming. As technology has improved, the system has stagnated or even regressed.

Until now, there simply hasn’t been a map for how to fix the outdated infrastructure in provider data management. Just think of the career of one single physician — at the start of their career, they likely have a certain license, work in a particular office, and perform at a certain practice. As they gain experience, that physician will likely face multiple credentialing moments, career changes, additional licenses or specialties. The hurdles they must overcome to make these updates are expensive and time-consuming. A simple blueprint to this process would be transformational.

Imagine if that physician only had to enter their data once, and that a tech-forward, AI-driven platform would keep it updated in a single, comprehensive source of truth for all networks?

That blueprint is here. And ready to become a change maker for physicians, hospital systems, and insurers alike.

There are systems and tools available (ones that don’t involve fax-machine transcription) for provider data management that can streamline processes, create data management standards, and yes, eliminate the repetitive process that comes as providers have to fill out 130 data fields. Advanced technology is available to support healthcare systems and payers in processing that data.

By drawing a line in the sand and setting a new standard for provider data management, we can create clarity and build industry consensus.

Certify: Your Single Source of Truth

In a system where provider data is fragmented and full of errors, Certify is a single source of truth. We can eliminate the hours spent filling in data fields repeatedly and become a foundational component of healthcare operations.

We want to eliminate transcribed faxes and screenshots and become the tech-forward platform that powers your provider's data management. We want old-school processes and dated technology to be a distant memory for providers and health plans.

We want to create the infrastructure to power your future. We want to be the connective tissue that forms the foundation for the next generation of healthcare operations—all with better patient access, faster payments, and operational ROI.

We want to say goodbye to millions in unnecessary costs, to error-prone databases, and yes, to screenshots.

Come on over, cross that line.

Data cleanliness never looked so good.

Are you ready to take the next step in re-architecting the foundation of provider data management? Book a demo with one of our provider data experts.