Are healthcare providers’ contact details as accurate as you think? In this podcast hosted by Chenny Solaiyappan, Curatus Chief Revenue Officer Jarrod Mandozzi speaks on solving healthcare’s provider data quality crisis. Jarrod shares insights from his extensive experience in Medicare and Medicaid programs, revealing how inaccurate provider information impacts patient care, health plan operations, and industry efficiency.
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Show Notes
- Healthcare is not for the faint of heart and requires deep passion and resilience.
- Dual enrollment for Medicare and Medicaid beneficiaries is a complex process that needs technological innovation.
- Provider data quality is a critical, often overlooked challenge in healthcare operations.
- AI and machine learning can significantly improve data cleansing and provider information management.
- Entrepreneurs in healthcare must stay focused and not get distracted by “shiny objects”.
- Technology can simplify complex government program enrollment for low-income seniors.
- Health plans struggle with maintaining accurate provider directories across multiple data sources.
- Credentialing and provider network management are increasingly complex in modern healthcare.
- Approximately 10% of provider data changes monthly, making continuous updates crucial.
- Ghost networks, where providers are listed at multiple locations, are a significant industry challenge.
- Successful healthcare startups need patience and discipline to navigate slow-moving industry processes.
- Social needs identification and member engagement are emerging important areas in healthcare technology.
- NPI databases are not always reliable for current provider contact information.
- Claims data can be a valuable source for verifying provider practice locations.
- Health systems and state agencies face similar provider data management challenges as health plans.
- Automated roster ingestion can simplify provider data updates for network partners.
- Technology can help identify and resolve provider data discrepancies more efficiently than manual processes.
- Healthcare entrepreneurs must believe in their mission and understand the industry’s complexity.
- AI presents both exciting opportunities and potential challenges in healthcare innovation.
- Comprehensive provider data management requires integrating multiple functions like directory management, credentialing, and network development.
About the speaker
About the host
Chenny Solaiyappan is the Director of Product Management for Cognizant Trizetto's Government and Quality Solutions, and a founding member of the ClaimSphere suite of products, encompassing quality, HEDIS ®, CMS Stars, and clinical solutions. An accomplished Intrapreneur and Lean Startup Practitioner, he plays a pivotal role in shaping the overall product strategy and serves as the HL7 DaVinci Business Co-chair. With a notable track record, Chenny has provided consultancy to over 30 health plans across the nation, consistently raising Quality and Star ratings in Medicaid, Medicare, Federal Employees Health Plan, and Commercial health plan sectors, collectively supporting 30 million lives. His outstanding leadership and innovative contributions have earned him prestigious awards, including the 2023 Top 20 Global Product Manager Award by Products That Count, as well as the 2021 and 2019 Product of the Year awards by Cognizant Trizetto.