Provider Directory Accuracy demo
Every directory listing checked against rosters, claims and provider replies; stale entries found before a member is sent to them. 1:15
What the demo shows
A data quality solution for health plans that checks every listing against rosters and claims.
Each listing becomes one evidence card: the directory entry beside the group roster, 24 months of claims at that address and the last attestation, mismatches flagged. Six agents read rosters, test claims, match the registry and licenses, send one request per group and draft the correction; the analyst approves and it publishes within 2 business days.
Transcript
- Provider Directory Accuracy checks every health plan listing against rosters, claims and provider replies.
- Federal reviewers found almost half of directory locations wrong.
- Each listing is one evidence card, directory, roster, claims and attestation, side by side.
- Dr. Castellanos is listed in Dayton.
- Her group quietly dropped her.
- Claims show nothing here in 12 months and 412 in Cincinnati.
- So the card flags a likely ghost one no attestation would catch.
- Dana reruns the check.
- Six agents show every step.
- She removes the listing and asks the group once, live within two days.
- Across the plan, 612 likely ghosts on a 90-day cycle.
- Built on Botminds: agents, data, screens, and governance on one platform.
Transcribed from the film’s narration. Captions are on the player.