ProviderTrust Launches DynamicNPI™: A Revolutionary Provider Network Eligibility Solution for Healthcare Payers

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Sep 18, 2024, 12:23 ET

NASHVILLE, Tenn., Sept. 18, 2024 /PRNewswire/ -- ProviderTrust, a leader in healthcare data and technology solutions, is excited to announce the launch of DynamicNPI™, an innovative connected data source designed to enhance the accuracy and reliability of provider networks for major payers across the country.

Access Verified, Connected Primary Source Data with Just an NPI

"Patient and member safety has been the driving force behind everything we do at ProviderTrust. Since our founding nearly 15 years ago, we've anchored to three core principles: creating simple, easy-to-adopt solutions, increasing efficiencies for backend teams, and reducing risk within our healthcare system," said Christopher Redhage, ProviderTrust co-founder and managing partner. "We are proud to be nimble and responsive to the needs of our clients, and today, we are excited to announce DynamicNPI–our most advanced data strategy to proactively address unique provider network challenges. This new solution not only enhances quality care but continues to prioritize member safety in industry-leading ways."

At the core of DynamicNPI is a revolutionary new data model that attacks the problem of provider network eligibility differently, verifying and connecting the industry's disparate data sources. By using the National Provider Identifier (NPI), a unique identification number for covered healthcare providers, DynamicNPI activates real-time provider eligibility updates that can be delivered directly to payer data workflows via API.

While existing processes rely heavily on self-reported data and manual verifications, DynamicNPI pulls from many disjointed sources including state licensing boards, federal and state exclusion/sanction lists, specialty boards, and more, offering the most comprehensive and up-to-date provider data on the market.

"We've seen firsthand the challenges that credentialing, provider operations, and management teams have experienced in getting timely, always up-to-date, and relevant provider eligibility information," said Mike Wirth, chief commercial officer at ProviderTrust. "The outdated process of manually verifying provider credentials is inefficient and prone to errors. DynamicNPI ensures that providers are continuously monitored across various data sources, including those sources that require providers to self-report data, offering real-time, ongoing insights into their eligibility. With DynamicNPI, payers can trust they're partnering with qualified professionals while also reducing the administrative burden on our nation's frontline healthcare providers."

States and federal agencies often struggle to communicate effectively, resulting in delayed updates on adverse events and gaps in provider eligibility data. DynamicNPI addresses this issue by proactively tracking and pulling data from many different sources to verify a provider's eligibility status in real-time. This includes ensuring that care providers are properly licensed and can legally practice in specific regions before appearing in payers' networks or member directories.

Key Features of DynamicNPI:

Proactive, real-time updates: Instantly verify provider eligibility and credential status.
Comprehensive data sourcing: Pulls from hundreds of unique sources to incorporate state license information, DEA registrations, exclusion/sanction data, primary source screenshots, and so much more to ensure a complete, trusted dataset.
Accurate identification: Uses NPI numbers to verify and augment data, ensuring payers can confidently trust the information.
First in the market: A unique approach that outperforms competitors relying on self-reported or stale data.

For more information about DynamicNPI or to request a demo, please visit providertrust.com or contact [email protected].

About ProviderTrust

ProviderTrust was founded in 2010 with a mission to create safer healthcare for everyone through OIG and state Medicaid exclusion monitoring. Today, the organization has developed the industry's most accurate dataset for ongoing exclusion monitoring and primary source verification, serving the nation's top health systems, payers, and pharmacy organizations. Our solutions monitor employees, vendors, provider networks, licenses, credentials, and more for OIG and state Medicaid exclusions, sanctions or disciplinary actions, license expirations, or suspensions. With a team of 100+ employees, our Nashville-based company has consistently been recognized as one of the Best Places to Work by Modern Healthcare, Inc. Magazine, and the Nashville Business Journal. To learn more, visit providertrust.com.

SOURCE ProviderTrust Inc