Provider Information Management

Get the provider information you need — all in one place

Finally, your agency can stop duplicating efforts reduce administrative waste. Learn more about the Provider Information Management solutions at Optum™.

Accurate provider information is vitally important. You use it for referrals, to verify credentials and make accurate payments. But many entities, including statewide health information exchanges, state Medicaid agencies, public and private health plans and provider systems, duplicate each other’s efforts. This results in data that is outdated, incorrect and costly.

Optum can help to centralize the collection, verification and redistribution of provider data, which can mean savings through reduced administrative waste and more effective communications between providers, plans and state programs.

Our provider information management solutions offer:

A comprehensive database

The Optum provider information management database includes more than two million providers, and enables users to authenticate providers, conduct network analysis, support credentialing with primary source verification, lower claims processing costs and much more.

Large-scale primary source verification

Leveraging our unique tools can help reduce the annually recurring costs of physician credentialing and free up important resources previously spent collecting provider data that is often incomplete and inaccurate.

Secure portals

Our partners have access to provider information though highly secure portals that minimize the likelihood of system abuse while allowing for direct updates.

Multiple access methods

Optum experts can build application program interfaces (APIs) to allow for custom, site-specific information requirements. Similarly, we can help you integrate other types of data to add further capabilities.

Provider Information Management can:

  • Reduce administrative waste by streamlining existing inefficiencies.
  • Take advantage of an accurate, verified, and single-source data set for providers.
  • Improve provider communications by implementing direct, secure messaging between providers, plans, statewide health information exchanges, and Medicaid enterprises.
  • Meet the requirements for ACA Section 1902 for assuring access to Medicaid services and show progress as defined by the HITECH Act. Federal funding may be available.
  • Help Health Information Exchanges establish foundations for a sustainable business models.