How Perspecta Streamlines Provider Data Mangement for Payers

From Chaos to Clarity: Streamline Provider Data Management for Payers & Providers

1/9/2025

by Mark Mozley

Accurate provider data is the cornerstone of healthcare and insurance organizations. It feeds into critical systems and downstream applications, directly impacting care journeys for health plan members and injured workers. Yet, managing provider data is no small feat.

In fact, it’s estimated that $4.7 billion is spent annually just to manage provider data.
With data constantly in flux—driven by licensing updates, employment changes, network adjustments, and acquisitions—the need for clean, enriched, and compliant provider data has never been greater. At Perspecta, we simplify the complexity with end-to-end solutions that drive accuracy, efficiency, and compliance.

Here’s how we tackle the challenge across four key areas:

(1) Roster Management
Provider rosters submitted to health plans are notoriously messy. Formats vary across providers, and even a single provider may shift their format unexpectedly. Homegrown tools often provide limited fixes but struggle to adapt when changes occur, creating downstream compliance risks.

We standardize roster files, transforming disjointed data into a consistent, usable format. By alleviating format headaches, we minimize errors and set the foundation for seamless downstream processing.

(2) Data Cleansing, Enrichment & Verification
Once rosters are standardized, the next step is cleaning, enriching, and verifying the data.

Cleansing: Correcting formatting errors, like excessive CAPS LOCK or inconsistent phone numbers.
Enrichment: Adding valuable fields, such as provider language capabilities or validated contact details.
Validation: Going beyond automation, we manually verify details through our call center. This is a unique advantage for workers’ compensation clients, where office acceptance of claimants often requires a direct phone call.

According to CAQH, provider practices spend $2.7 billion and health plans spend over $2 billion annually on inefficient and redundant work to ensure the accuracy of directory data.

With Perspecta, clients receive clean, enriched, and verified provider data that’s ready to drive meaningful action.

(3) Provider Data Management (PDM)
Beyond roster management and cleansing, PDM unlocks deeper insights. Health plans can score providers on cost, quality, and performance metrics, enabling smarter decision-making.

Perspecta’s PDM solution integrates seamlessly into existing workflows, offering a single source of truth for provider data.

(4) Provider Directory
Data’s value lies in its accessibility. Perspecta’s Provider Directory is the presentation layer where clean, accurate, and enriched data becomes actionable. Whether improving member search experiences, supporting referrals, or enhancing care journeys, our directories ensure that high-quality provider data translates into better outcomes.

Supporting the Full Data Lifecycle
Perspecta’s solutions don’t stop there. We also provide:

By addressing every step of the provider data lifecycle, we empower healthcare payers and providers to meet regulatory standards while improving operational efficiency and patient care.

Why Perspecta?
At Perspecta, we turn raw, messy provider data into actionable insights with 95% provider data accuracy. From Roster Management to Provider Directory, our comprehensive solutions ensure data accuracy, regulatory compliance, and improved healthcare outcomes—every step of the way.

Let’s talk about how we can help!

Learn more about Perspecta's Provider Directory solution

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