Health Provider Directory Management- PRIME

Accurate provider data
is also a federal compliance issue, thanks to the 2022 No Surprises Act, which mandates that health plans:

  • Refresh provider data within directories at least every 90 days

  • Make provider-submitted changes in downstream systems within 2 days

  • Remove all listings for unverified providers

The result, for insurance plans, is an urgent need that they often do not have the resources or expertise to meet. For their part, doctors often cannot manage the demands of multiple insurance plans – each with their own forms – and overtaxed practice admins may dismiss insurance plan requests as junk mail.

PRIME — a service of Atlas Systems — solves the provider data dilemma with a rigorous, proven approach to provider data validation and management. We achieve best-in-class provider data accuracy with 95% client-audited quality assurance and up to 90% validation success. While other services rely on data aggregation – using sources of unknown reliability – PRIME delivers data validation from the source, reaching out directly via convenient channels to contracted health systems, provider groups, and individual practitioners.

Our capabilities also extend beyond provider data validation to include:

Ongoing provider network monitoring

leveraging the Limited Access Death Master File and other key resources to help you keep your listings accurate and complete, with no hassles or worries

Directory fulfillment and printing

delivering instant, high-quality, and ADA-compliant versions of your directory on paper or in PDF

Mock audit preparation

bringing extensive experience with audit preparation, including mock CMS and state provider directory audits; we identify data errors and anomalies to help prevent potential compliance violations in advance of an actual audit

Provider training

leveraging state-of-the-art technology to provide a positive, structured, and fully customizable training experience for SNP MOC and more


Animesh Mozumdar
Chief Business Officer


How can health plans and providers cope with growing demands to deliver great experiences and regulatory compliance in 2024?


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