V12 Intelligent Provider Directory is a proactive, self-correcting, data engine that solves for costly compliance and provider data inaccuracies.

Consolidate Multiple Provider Data Sources

V12 IPD is a robust and scalable platform that consolidates multiple provider data sources (both internal and external) such as CMS data, purchased or subscribed data, to build a complete up-to-date and accurate provider profile. This profile can be used for both in and out of network providers for ranking, querying and network adequacy, as well as for OIG compliance checking used in the credentialing process. 

Pre-mapped connectors for popular data sources and tested processes for Managed Care Organizations, Integrated Physician Networks, Accountable Care Organizations (MCOs, IPNs, ACOs), Health Systems and more. Organizations need flexibility and speed to market. V12 IPD is the answer!

Pre-Built V12 IPD Data Sources:

National Plan and Provider Enumeration System (NPPES)

CAQH ProView

Custom API-based integrations and ongoing data file transfers are also available in the V12 Intelligent Provider Directory application. Common additional data source integrations include: Claims/Adjudication Systems, Provider Directory Applications, Electronic Data Warehouses, State Registries (Medicaid lists), Provider Rosters, Network Adequacy Applications, etc. 

Let the Data Decide!

Stay up to date on provider demographic and network data changes based upon your preferences. The V12 Intelligent Provider Directory application puts the power back in your hands and gives you the ability to decide which data sources are most accurate in specific scenarios. The end result: a highly customized provider directory “engine” capable of weighting data based upon your workflow logic and scoring domains. At Virsys12, we believe tools like the V12 IPD solution will help payers and providers alike adhere to ever changing provider data accuracy mandates such as the CAA. 

Custom Data Scoring Domains:

Data Age

Source System Trust

Completeness of Data

Data Derivation

Data Consensus

Detail Significance

Flexible Workflows to Keep Your Directory Accurate

Provider directory maintenance is not always black and white. With the V12 IPD application, you get to decide between a fully automated solution and certain outlier scenarios that may require internal review or an approval process. Both approaches are accounted for and encouraged by our users. The V12 Intelligent Provider Directory application features a Salesforce user interface component to quickly make provider data update decisions in a queue-based fashion with the option to trigger approval cases for further review. Irrespective of the approach, the V12 IPD application is designed to reduce manual input and improve provider data accuracy with automated workflows, all while keeping the provider directory as accurate as possible.

The Risks are High for Inaccurate Provider Data & Directories

Claims Payment Risk

Improperly-paid claims

Claims adjustments

Lengthy, expensive recoupment

OIG exclusions go unchecked

Regulatory Risk

Non-compliance

Costly fines up to $25k/incident

Coverage Risk

Perceived as deception

Non-compliance

Costly fines

Quality Risk

Disconnected provider data

Inability to manage costs narrow

Read V12 IPD's Complete Product Guide

Ready to learn more about V12 IPD? The breadth and functionality of V12 IPD spans far beyond one page of information, but this quick, in-depth overview will help you start digging in.