Virsys12 Boosts Healthcare Operations with New Provider Data Management Features

Enhancements to V12 Network and V12 Provider Data Engine empower healthcare organizations to deliver seamless provider experiences and maintain accurate provider directories

Virsys12, a leading provider of solutions for provider network management and ongoing provider data management and directory updates, today announced at the ViVE conference in Los Angeles, CA, new features in its flagship SAAS applications, V12 Network and V12 Provider Data Engine (PDE). With its robust and scalable platform, Virsys12 continues to empower healthcare organizations to eliminate inefficiencies in their provider data management and workflow processes.

“Our team is thrilled about the latest advancements in V12 Network and V12 PDE, solidifying our commitment to provide health plans and providers with the best enterprise provider data management solutions available,” stated Virsys12 Chief Technology Officer, Seth Hobgood. “These features not only showcase our dedication to excellence but also set a new standard in the industry, ensuring that our products remain at the forefront of technology aimed at optimizing provider network operations.”


V12 Network

V12 Network is a comprehensive operational platform for provider network management. The solution helps organize and manage fragmented provider data necessary for onboarding, credentialing contracting, and network operations, fostering a deep collaboration between providers and payers.  Highlights of what’s new in V12 Network, include:

  • Network Builder: Kickstart a network by using the Network Builder tool to facilitate bulk data creation for PGPs and PRs based on search criteria identifying included plans/networks as well as provider groups, ancillary groups, or facilities and their associated locations. Eligible practitioners can be identified by criteria such as: specialty or taxonomy, address or practicing counties, name, NPI, TIN.
  • Network Manager: Automatically create or remove provider directory records for practitioners that should be added to or removed from a network based on criteria defined specifically for that network. Include or exclude valid records by specifying key details about practitioners or locations that should be included.
  • Integration with CAQH ProView: Streamline provider demographic data matching and update capabilities, including provider license matching, through our integration with CAQH.

“The Network Manager component of V12 Network is particularly exciting as it allows our customers to set specific criteria for their networks, and dynamically generate all the records for that network and practicing locations based on specialties within designated areas,” continued Hobgood. “It also seamlessly associates practitioners with reimbursement terms and contracts and keeps them in sync. If any of the practitioners are no longer included in the criteria set by the client, the Network Manager component will then recommend that they be terminated from that network. It’s a great way to dynamically add or remove certain records from your network based on the criteria you set.”



A companion product to V12 Network, V12 PDE is intended to operate as a proactive, self-correcting provider data engine taking the guesswork out of provider directory curation and ongoing maintenance, thereby reducing tedious manual processes and lowering regulatory risk for inaccurate provider data per CMS requirements. Key new features in V12 PDE, include:

  • Data Queue Management: Proactively update provider demographic information, enable mass update capabilities for provider groups, and automatically generate Salesforce cases and approvals.
  • Custom Data Field Mapping: Update provider data based on “groupings,” increase data auditability, and implement manual or automatic data override functionality.
  • Data Source Scoring Configuration: Use AI to rank each data source according to six distinct domains: Data Age, Source System Trust, Completeness of Data, Data Derivation, Data Consensus, and Detail Significance. These rankings can be adjusted in near real time by administrative users.

“We’ve focused many of the new enhancements in V12 PDE to address the evolving challenge of provider data management in healthcare organizations, particularly regulatory challenges tied to government regulations on provider directories and pricing transparency,” continued Hobgood. “This application processes data from various provider data sources, including provider demographics, provider taxonomies and specialties, and practicing location (both master address location data and practitioner address data). It then scores the ingested data and recommends updates to the source of truth for the provider directory, so it’s a powerful tool for any organization looking to maintain accurate provider data.”

“Inaccurate provider data is typically the root cause of many pricing transparency and surprise billing issues in healthcare today. With V12 Network and V12 PDE, Virsys12 offers enterprise solutions that tackle the complexity of provider data management, providing a vital step toward comprehensive healthcare optimization,” concluded Virsys12 Chief Customer Officer, Peter Schmidt.

To learn more about how Virsys12’s enterprise approach to workflow automation for provider data management, visit:


About Virsys12

Virsys12 empowers healthcare organizations with the technology needed to eliminate inefficiencies in provider data management and workflow processes. Through customized applications that simplify provider network and lifecycle management, our solutions address a variety of use cases, including provider onboarding, credentialing, contracting, network operations, and data management. Our leading SAAS products, V12 Network and V12 Provider Data Engine (PDE), help streamline processes, improve communication, and ensure accurate and up-to-date information about healthcare providers within a network.