Provider Network Compliance

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Provider data accuracy and compliance has become a major risk item for most health plans.

Over 45% of Medicare
provider directories
are inaccurate

23 Health Plans
were issued a notice
of non-compliance

Fine of $25,000/day
per MA beneficiary

As CMS cracks down on Medicare Advantage plans, Glenridge technology helps health plans validate data, and ensures data accuracy and regulatory compliance. Our results and outcomes have significant downstream benefits for our clients including:

  • Improved claim accuracy
  • Reduced member calls & dissatisfaction
  • Federal & state compliance
  • Mitigated risk of fines & suspension
  • Enhanced provider engagement

Additionally, Glenridge streamlines the Attestation process allowing providers to review current directory data quickly and easily.