Unveiling the Critical Role of Provider Data in Health Plan Operations

why provider data is key

In the dynamic landscape of healthcare, the accuracy and currency of provider data have become paramount for the survival of health plans.  My recent article in Forbes, “The Data Behind The Provider Directory: Why Provider Data Is Key,” delves into this topic and the crucial role of provider data in optimizing workflows, ensuring precise claims […]

Q&A with Virsys12’s CTO, Seth Hobgood

Seth Hobgood

What are you most excited to be working on this year at Virsys12? This year, a key focus for us is enhancing our V12 Provider Data Engine (PDE) product to tackle the challenge of ever-changing provider data in healthcare organizations. This application processes data from various provider data sources, including provider demographics, provider taxonomies and […]

Healthcare on Overdrive: Why an Enterprise Provider Data Strategy is a Must for Health Plans

provider data strategy

In the ever-evolving landscape of healthcare, where labor costs intensify and regulatory complexities surround provider networks and directories, health plans find themselves at a crucial juncture. The need to reimagine their approach to working with providers has never been more apparent. Fragmented engagement, siloed data, and disparate systems are becoming obsolete and unmanageable. To navigate […]

Five Reasons Companies Struggle With CRM Implementations

Tammy Hawes, CEO, and Founder of Virsys12, explores the hurdles organizations face in successfully implementing CRM systems in her Forbes Technology Council article. While CRM systems offer the promise of improved customer relationships and streamlined processes, Hawes identifies five common reasons behind implementation struggles. These include insufficient executive support and employee buy-in, the temptation to […]

Why Provider Network Management Is Important For Health Plans In 2023

regulatory requirements

Before founding Virsys12, I started my career as a software developer in healthcare and ultimately held rolls as a CTO and CIO. It was evident to me that there was room for improvement in the automation of business processes in healthcare to eliminate waste and improve efficiencies. We believe there is no better place to […]

How to Improve Patient Engagement for Healthcare System Success

improve patient engagement

If we truly want a healthcare system in America that’s both effective and efficient, we should focus on patient engagement, in which clinicians communicate clearly with patients and patients share in making decisions and managing their conditions. This means that providers must make the effort to get to know their patients, communicate honestly with them […]

Why We Should Embrace Digital Healthcare

digital healthcare

It’s a truism that the pandemic dramatically sped up the digitizing of our lives, with the ubiquity of teleconferencing today being the most obvious manifestation of this trend. But that’s just the tip of the iceberg. Perhaps the most dramatic change has been the rise of digital healthcare–and this is good news for all of […]

How Building Behavioral Health Networks Can Help Solve the Mental Health Crisis

building behavioral health networks

Almost one in five American adults live with a mental illness, up to 51.5 million people in 2019, according to Mental Health America. Depression is one of the leading causes of disability, and people with severe mental health diagnoses die two decades prematurely. The mental health crisis is even more dire for young adults in […]

Moving Enterprise Systems to the Cloud is Key in Eliminating Waste

moving enterprise systems

According to a study published in JAMA, 20-25% of healthcare spending is wasteful, costing at least $760 billion per year. Administrative waste, the excess overhead that occurs primarily due to the complexities between providers and payers including time devoted to billing and reporting, is the largest area of waste and accounts for $266 billion a […]

Virsys12 + Becker’s Hospital Review Webinar

The success of payer-provider partnerships depends on a new level of collaboration. Keeping up with the expectations of members and patients regarding how they access, engage and experience healthcare requires a new type of partnership. At Virsys12, we believe clean, accurate provider data plays a critical role in transforming the business of healthcare. This webinar […]

Keep Your Providers in Network Happy

When it comes to building and managing a provider directory in healthcare, the provider network can be complicated, especially because it must be kept compliant and up to date. Your provider onboarding and credentialing team try their best to juggle it all, but it can be easy for them to fall short. This is largely […]

What ACOs Need to Know to Meet the Demands of ACO REACH and Unlock its Benefits


In an effort to lower healthcare costs and improve quality of care and access to care, the Centers for Medicare and Medicaid Services (CMS) Innovation Center recently cancelled the Geographic Direct Contracting Model and is phasing out the Global and Professional Direct Contracting Models (GPDC) at the end of 2022. Participants that meet requirements will […]

5 Ways Providers are Transforming the Patient Experience with Salesforce

5 Ways Providers are Transforming the Patient Experience with Salesforce Health Cloud The widening affordability gap and the rise in high-deductible health plans have pushed patients to assume more responsibility for their medical costs. With this additional responsibility, consumers have taken a more active role in their clinical journey. Patients are paying more for care […]

Virsys12 + ProviderTrust Webinar

Best-in-Class Provider Network Management

Executive leadership from ProviderTrust and Virsys12 discuss managing the complexities of provider data and network management for providers and payers. From onboarding and recruiting to contract negotiations to setup of reimbursement models for claims payments, we explore the challenges that face payers and providers across the provider lifecycle and how best to manage in 2022 […]

Accelerating Healthcare Innovation With Cloud Data Analytics

healthcare innovation with cloud data

Accelerating Healthcare Innovation With Cloud Data Analytics Cloud technology, machine learning, and in-depth analytics across the healthcare industry are redefining patient care, patient experience, provider experience, and innovation. Learn about the latest trends in healthcare cloud solutions and analytics and how they’re fueling the next wave of healthcare innovation. 3 Ways Cloud Computing Will Redefine […]

Improve Claims Payment Integrity and Reduce Provider Burnout

improve claims payment integrity

Why Is Accurate Provider Claims Payment Difficult for Healthcare Payers? Claims processing for payers is a complex process with combination of value based and fee for service models, market expansions, and acquisitions. This process also often requires multiple disparate systems. After layering on the constant changes to provider data and the process to onboard, credential, […]

How Healthcare Companies are Taking Advantage of Intelligent Automation

Healthcare Companies are Taking Advantage of Intelligent Automation One thing that healthcare has an abundance of is required forms to be completed… tons of forms. It seems as though every time you go to the doctor, they ask you to fill out the same stack of forms again and again and again. Salesforce recently announced […]

Get More From Digital Engagement in Healthcare

Is Digital 360 worth the hype? The short answer is “absolutely”. Virsys12 has been in the Salesforce ecosystem for nearly 10 years, and during that time we’ve completed almost 1,000 projects focused primarily on the healthcare industry. Our clients are always looking for better ways to keep healthcare consumers engaged and up to date. From […]

Complex Relationships with Providers in Healthcare

complex relationships with providers

Healthcare organizations have complex relationships with their providers and there are solutions to help with tracking all the steps in Provider Lifecycle Management. Cloud-based technology like Salesforce is available to automate the process of onboarding providers, streamline documentation associated with credentialing and contracting. Salesforce is the digital solution every healthcare organization needs for more productive […]

How To Efficiently Maintain Healthcare Relationship Management

efficiently maintain healthcare relationships

Using a Transformative Digital Landscape to Accelerate ROI The digital landscape went from separate spreadsheets and documents to taking all those items necessary to communicate in a cohesive way with patients and health plan members in a cloud system like Salesforce. Also, knowing medical conditions and preferences about patients and members is critical for organizations […]

Why Salesforce is Right for Healthcare Database Management

Database management

Salesforce Database Data isn’t just at the center of your business, it’s at the heart of everything you do, and that’s never been truer than in today’s environment. As data has gotten bigger, the challenge of managing it has grown along with it. That’s why Salesforce is right for healthcare database management.  In the healthcare […]

Solving the Healthcare Provider Directory Challenge

$2.76 billion annually. Nearly a thousand dollars a month (per provider). That’s how much provider directory maintenance is now costing physician practices nationwide, according to a new survey by the Council for Affordable Quality Healthcare (CAQH). As practices work with more providers and contracts, that tab only gets higher. On the other side of the […]

Healthcare Technology Tackles the Patient Billing Challenge

Healthcare and heavy cost seem to go hand in hand these days

In the clinical environment, the mantra is clear: we have to put patients at the center of care. But when it comes to billing and reimbursements, the reality is, the patient has always come last. Anyone who’s been a patient recently knows this all too well. You receive the bill and have no idea what […]

How Technology is Transforming Healthcare Relationship Management

efficiently maintain healthcare relationships

This week is U.S. National Health IT Week, a nationwide action week focused on catalyzing change within the U.S. health system through the application of information and technology. As part of the initiative this year, organizers HIMSS and the Institute for e-Policy have highlighted five points of engagement that demonstrate how information and technology can […]

Making Progress Toward Healthcare Interoperability

When healthcare leaders talk about things like improving efficiencies, lowering costs and using data more effectively to improve individual and population health, the discussion invariably turns to interoperability. But just what is interoperability? HIMSS defines it as “the ability of different information systems, devices or applications to connect, in a coordinated manner, within and across […]

5 Change Management Practices for Healthcare Transformation Success

The move to value-based care means healthcare leaders today are being tasked with guiding their organizations through massive strategic transformations to improve quality, efficiency and effectiveness. These initiatives involve implementing new systems and processes that affect everything from financing to service delivery to the need for increased connections and collaboration with other entities and providers. […]

Virsys12 Launches a New Podcast to Highlight Healthcare Transformation

How I Transformed This spotlights successful industry leaders. Long before cloud solutions were widely adopted in the healthcare industry, Virsys12 was transforming the business of value-based care with Salesforce. With the increasing speed of change and the complexities in new reimbursement and business models, our innovative team is focused on transforming how healthcare is consumed […]

How Salesforce Einstein Analytics and Health Cloud Could Change Healthcare

Healthcare organizations are looking for ways to be impactful in their markets and better serve their patient population and the old ways and use of EMR systems as the only technology to manage patient care is no longer a viable solution. Health systems need to collaborative, technology-driven patient engagement and outreaach. Salesforces already helps healthcare […]

7 reasons to use Salesforce in healthcare

So you think “how does Salesforce help healthcare organizations?” Transform and automate with the Salesforce platform. Virsys12 has been focused on the implementation of Salesforce for healthcare organizations since 2011. We saw the need and the tidewave of innovation and demand by the patient consumer, government regulation and the overwhelming administrative burden put on the operations […]