The Virsys12 Advantage: Winning Provider Network Management with Data-Driven Automation
Continuing our analysis of why healthcare leaders must choose innovation over status quo in provider network management In “Winning the Provider Network Game: Why Data Accuracy is Non-Negotiable”, we established a fundamental truth that many healthcare technology vendors prefer to avoid: sophisticated workflow management and AI automation are worthless if they operate on inaccurate data. […]
Winning the Provider Network Game: Why Data Accuracy Is Non-Negotiable
A candid analysis of where the provider data management industry stands today – and why your technology choices will determine your competitive advantage for the next decade After spending the past year analyzing the healthcare technology landscape and engaging with industry leaders at conferences like AHIP and ViVE, one thing has become crystal clear. We’ve […]
The $2.76 Billion Provider Network Problem Healthcare Can’t Ignore
The sobering truth about provider data management that every healthcare executive needs to know Here’s a number that should keep every healthcare administrator up at night: $2.76 billion annually. That’s how much provider directory maintenance is costing physician practices nationwide, according to recent research by the Council for Affordable Quality Healthcare (CAQH). We’re talking about […]
From Compliance to Competitive Advantage: The New Era of Provider Networks
A candid analysis of where the provider data management industry stands today – and why your technology choices will determine your competitive advantage for the next decade After spending the past year analyzing the healthcare technology landscape and engaging with industry leaders at conferences like AHIP and ViVE, one thing has become crystal clear: we’ve […]
Provider Network Intelligence in Motion – The V12 Enterprise Advantage
The Need for an Active Provider Data Strategy Health plans, payers and health systems are struggling with provider data not because they lack information, but because they lack the systems to act on it. Provider data is only valuable if it’s put to work, and that’s where V12 Enterprise excels. The V12 Enterprise Provider Data […]
Stop Managing Spreadsheets, Start Managing Provider Networks
The Provider Data Spreadsheet Trap In many healthcare organizations, provider network management still relies heavily on spreadsheets. While spreadsheets are familiar and flexible, they are fundamentally ill-suited to manage the complexity of modern provider networks. Spreadsheets can track provider demographic data, but they don’t provide the infrastructure to support the complex relationships required to track […]
The Provider Data Myth: What Quality Provider Data Really Means
What Does “Quality” Actually Mean? “We have quality provider data.” It’s a phrase often heard in boardrooms and strategy meetings, yet it rarely holds up under scrutiny. The myth of quality provider data stems from a narrow definition of what “quality” actually means. Most healthcare organizations measure provider data quality by its accuracy at a […]
Good Provider Data Isn’t Enough: Why Healthcare Still Struggles with Provider Data
The Illusion of “Good Enough” Provider Data In today’s data-driven healthcare landscape, one of the most persistent myths is that having the “right” provider data is enough. Healthcare organizations invest heavily in data acquisition, cleansing, and management, especially when it comes to provider data. But provider data is always changing, and many organizations still find […]
Transforming Healthcare, One Quarter at a Time
At Virsys12, Q2 was marked by growth, recognition, and continued leadership in transforming healthcare through technology. From national honors to insightful thought leadership and strategic advisory board expansions, we remained focused on driving innovation. This recap highlights the key moments of the quarter and how we’re shaping the future of provider data. Becker’s Women in […]
From Manual Mayhem to Predictive Precision: The New Era of Provider Data
Manual provider data management isn’t just outdated, it’s operationally risky. Spreadsheets. Email follow-ups. Periodic roster reviews. These legacy processes are slow, expensive, and prone to error. Fortunately, AI-powered platforms are changing that by introducing real-time data flow and intelligent oversight across the entire provider lifecycle. How Health Plans Are Modernizing To illustrate, here’s how leading […]
Cutting Through the Hype: What AI Really Means for Provider Data Management
AI is everywhere in healthcare, but when it comes to provider data management, clarity is more valuable than hype. The Real Challenge Isn’t Technology The reality? Technology is rarely the issue. Today’s systems can automate credentialing checks, validate provider primary source and demographic information, and integrate with CVOs, licensing boards, and state agencies. However, the […]
Scaling Provider Networks: Why Lifecycle Visibility Matters
As value-based care, telehealth, and multi-state plans expand, provider networks are scaling faster than ever before. But without lifecycle visibility-into credentialing, license status, recredentialing, and provider changes growth creates risk instead of opportunity. After all, lifecycle visibility isn’t a luxury. It’s a requirement for scaling smart, staying compliant, and optimizing provider onboarding. The Pressure to […]
How Centralized Provider Data Reduces Compliance Risk
Compliance isn’t just about checking boxes it’s about staying ahead of risk, avoiding penalties, and ensuring provider network integrity. But when provider data is fragmented across credentialing vendors, HR teams, and spreadsheets, even the best compliance teams are flying blind. Centralizing provider data, therefore, allows you to reduce exposure, streamline audit prep, and avoid costly […]
Prescription for what payers and heath systems need for PLM
In the world of healthcare, there’s a hidden challenge that affects everything from patient care to administrative costs: provider data management. At Virsys12, we’re tackling this challenge head-on, and we’re excited to share how we’re revolutionizing the industry. Let’s dive in! The Provider Data Dilemma Ever tried to find a new doctor and ended up […]
Beyond Directories: How Intelligent Provider Data Management is Transforming Healthcare
Discover how AI-powered Provider Network Intelligence (PNI) is revolutionizing healthcare provider data management, delivering 90% directory accuracy and 56% faster credentialing through intelligent automation.
The Technology Revolution in Healthcare Provider Data Management: Why 2025 is the Turning Point
As recently discussed in our Forbes article “The Technology Revolution In Healthcare Provider Data Management: Why 2025 Is The Turning Point,” The healthcare industry is facing a transformative moment in provider data management. With the 2026 REAL Health Providers Act fast approaching, organizations are under mounting pressure to modernize outdated processes and meet new regulatory […]
Streamlining Provider Contract and Fee Schedule Management with V12 Network
Efficient provider contract and fee schedule management is essential for health care organizations in both a “build” or “manage” the network status. Yet, many health care organizations continue to struggle with archaic provider contracting technology or processes, fragmented data including complex reimbursement arrangements, and manual downstream data entry to critical billing/claims applications. Enter V12 Network—a […]
Why Manual Provider Directory Updates Are Failing Healthcare
As I recently discussed in my Forbes article, “Why Provider Directory Mandates Are Failing In Healthcare,” the healthcare industry is grappling with a crisis in provider directory accuracy—one that manual processes simply cannot fix. A new study in The American Journal of Managed Care (AJMC) has provided compelling evidence reinforcing what many of us in healthcare […]
Creating Unified Healthcare Solutions: Insights from Virsys12 and Conga on Integrated Provider Data Management and Contracting
In the rapidly evolving healthcare industry, the need for seamless provider data management and contracting processes has never been more critical. Healthcare organizations face significant challenges in managing provider data and contracts across multiple systems. This leads to inefficiencies and lost opportunities to improve care delivery. In this Q&A, Tammy Hawes, Founder and CEO of […]
Provider Lifecycle Management: The Build vs. Buy Dilemma
When healthcare organizations look to implement a provider lifecycle management (PLM) system, they face a critical decision. Should they build a custom solution from scratch or invest in a specialized solution from a vendor? A truly comprehensive PLM system—covering provider onboarding, credentialing workflows, contracting with fee schedules, claims activation, ongoing provider data management, and provider […]
Streamlining Provider Data Management & Directory with V12 Network
Accurate and efficient provider data management is critical to the success of any healthcare organization. Let’s face it, provider networks are complex. The need to maintain up-to-date, comprehensive directories has never been more critical. Yet, many organizations struggle with the intricacies of managing multiple provider data sources, keeping pace with regulatory requirements, and ensuring that […]
2026 REAL Act Countdown: Is Your Provider Data Ready to Make a Splash?
In the world of healthcare, change is the only constant. But the wave of transformation heading our way with the REAL Health Providers Act is more like a tsunami. Set to crash into the industry in 2026, this legislative behemoth is set to revolutionize how we manage provider data. The question is: will your organization ride […]
The Role of Technology in Transforming Provider Network Operations
In the ever-evolving landscape of healthcare, provider network operations serve as the backbone of the provider lifecycle. Efficient management of these operations is critical, ensuring that the lifecycle continues seamlessly long after initial enrollment, onboarding, and credentialing are complete. Yet, the sheer complexity and volume of these tasks often result in operational bottlenecks that can […]
Maximizing ROI with Virsys12: Real Success Stories and Powerful Tools
In today’s fast-paced healthcare environment, efficiency and accuracy are crucial. At Virsys12, we are committed to providing solutions that not only streamline workflows but also deliver significant returns on investment. We are excited to highlight some of the remarkable successes our clients have achieved, introduce our powerful ROI Calculator, and share insights on the benefits […]
Key Takeaways on Combating Siloed Data in Healthcare
Efficient data exchange is crucial in today’s healthcare landscape, yet the industry grapples with siloed data—information trapped within different departments, systems, or organizations. This fragmentation hinders collaboration and optimal patient care. My recent article in Forbes, “Unraveling The Chaos: How Siloed Provider Directory Data Undermines Pricing Transparency,” takes a look at this issue. Here are […]
The Role of Incorrect Provider Directories in Surprise Medical Billing
Imagine visiting a doctor you believe is covered by your insurance, only to later receive an unexpected, hefty bill. Sound familiar? You’ve fallen victim to surprise medical billing. And a significant culprit behind this issue is inaccurate provider directories. Surprise medical billing occurs when you visit a doctor you think is part of your insurance […]
Tackling the ‘Ghost Provider’ Dilemma: The Critical Need for Accurate Healthcare Directories
Have you come across the term “ghost provider”? A ghost provider is a healthcare professional listed in a health plan’s provider network but is not actively participating or accepting members under that plan. Often, these inaccuracies in provider directories arise due to the challenging and labor-intensive process required for both providers and payers to maintain […]
Unveiling the Critical Role of Provider Data in Health Plan Operations
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
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
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 […]