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 […]
How to Build Better Behavioral Health Networks
Healthcare Business Today More than 50 million Americans live with or experience mental illness, according to Mental Health America. This leads to increased disability claims, missed experiences, premature death and even suicide. It’s a problem that needs a solution. Thankfully, recent legislation and federal investments have been made in pursuit of better support and resources […]
Why Provider Network Management Is Important For Health Plans
Before founding Virsys12, I started my career as a software developer in healthcare and ultimately held roles 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 […]
Why We Should Embrace 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
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 […]
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 […]
Virsys12 + ProviderTrust Webinar
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
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
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 data… tons of datea. It seems as though every time you make any change to your provider network data a new form is required. And they payer may ask you to fill out the same stack of forms again […]
Get More From Digital Engagement in Healthcare
Is Digital 360 worth the hype? The short answer is “absolutely”. Virsys12 has been in the technology industry 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
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 is available to automate the process of onboarding providers, streamline documentation associated with credentialing and contracting. V12 Network is the digital solution every healthcare organization needs for more productive days […]
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 […]
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 Innovation Has Transformed Healthcare
From Spreadsheets to Smartphones: How Innovation Has Transformed Healthcare was a key topic of Tammy Hawes’ podcast episode at HIMSS19. It’s been two months since Virsys12 attended and presented at HIMSS19 and while the excitement from the event has faded, the ideas, discussions, partnerships and collaborations that stem from the event are just taking root. […]
Swimming in data
Image, courtesy Nashville Healthcare Council “Swimming in data” is a phrase just about everyone working in healthcare today can relate to. At a Nashville Health Care Council (NHC) luncheon last week, Dr. Toby Cosgrove pointed out that, not only are healthcare organizations overloaded with data, they’re struggling to make meaningful use of it. And that’s […]
Transformation in Healthcare Takes Vision, Leadership and Technology
This is an expanded version of an article that originally appeared as part of a sponsored profile in the Nashville Post. Every day, we hear about another remarkable advance in healthcare technology. As more of these new technologies are launched, healthcare organizations are investing tremendous amounts of money into them, expecting these solutions to help […]
Payers + Providers: What I Didn’t Know Then
I remember the first time I had to make my own decision about selecting a healthcare plan. It was overwhelming for a young woman just out of college. Happily, the benefits person at my office was very helpful and most of my following experiences with what the healthcare ecosystem calls “payers” has been positive however, […]
The Game Changer Award Goes to… Customer Service
When you think about health tech (and the B2B space more broadly), the first thing you think of is likely not customer service. Nonetheless, the buzzwords of health tech—interoperability, blockchain, AI, and the like—only find their meaning when combined with great implementations grounded in excellent customer service. When Virsys12 was asked to be a part […]