Provider Registry

In today’s fast-paced market, key aspects of your healthcare delivery and operations rely on having complete provider data. But for many organizations, managing this data can be quite a challenge. When drawing provider data from a variety of sources, it is often fragmented, full of errors, and incomplete. In fact, nearly half of all provider directory data is inaccurate according to a study by the Centers for Medicare and Medicaid Services (CMS). Compounding this challenge are the manual processes used to organize data, which can consume valuable time and resources.

Milliman MedInsight’s Provider Registry seamlessly consolidates provider data into a unified, up-to-date, and easily accessible dataset. We leverage patented technology and extensive reference data assets to enrich provider claims records, replace missing fields, and establish provider to group practice affiliations and facility relationship – all of which work to ensure your organization is using the best data available.

With Provider Registry, your organization can benefit from the following financial and administrative improvements:

Centralized, analysis-ready data

Ensure accuracy across teams with access to comprehensive information representing all US-based providers and group practices, including billing and servicing NPI, place of service, provider/clinician, group practice, clinic/location, and affiliation metrics.

Quality provider data

Enhance decision-making and resource planning with a unified data model that integrates data from diverse sources, such as public programs, CMS, and internal data, and plugs directly into your workflows.

Administrative ease

Optimize resource allocation and streamline processes (e.g., referrals, scheduling, and billing) by minimizing errors and delays stemming from incorrect billing, missing information, and duplicate records.

Improved healthcare delivery

Promote in-network, coordinated care for better outcomes and greater satisfaction with data that deliver insights into provider-to-practice relationships and connect patients with the right healthcare professionals.

How It Works

MedInsight Provider Registry Data

Provider Registry in action

Real world evidence-based practice alignment for an example physician

A single provider may practice at multiple locations, and, when those locations are owned by different provider groups and aligned with different health systems, it is easy to get lost when analyzing provider or provider group performance. However, Provider Registry makes it easy to understand the way these elements are connected and help you carry out the exact analysis you need.

Use cases: How Provider Registry can help

Provider master data management

Improve data quality, reduce errors, and enhance operational efficiency to gain a comprehensive view of your provider network, identify gaps in care, and optimize resource allocation.

Network adequacy

Identify and assess the number, specialties, and geographic distribution of provider groups to meet the healthcare needs of your patient population.

Provider relationship management

Understand provider to group practice affiliations and facility relationships to enable effective care collaboration and streamline referral processes.

Provider group analysis

Analyze the composition and performance of provider groups to identify high performing groups and opportunities and impact patient outcomes, cost efficiency, and utilization patterns.

Network management

Make informed decisions regarding network contracting, provider network optimization, and quality improvement initiatives to enhance collaboration and improve outcomes.