HMS Compliance Solutions™

HMS Compliance Solutions

Regulatory Problem: State legislators are creating new complex compliance regulations.

And the stakes are high. The industry is responding with new business processes and reporting solutions. However, this is not the primary challenge. The most difficult challenge businesses must overcome to get state compliance right is an issue that has plagued the healthcare industry for decades: Bad Provider Data.

Data Challenge: Healthcare Provider Data is Ever-Changing and Difficult to Maintain

Every healthcare provider can have multiple addresses, tax ids, group practice and hospital affiliations, name changes due to marriage or divorce, multiple state license numbers and status changes, and sanctions. Without a system to keep up with all of these changes, the result is bad provider data. To comply with new state regulations regarding physician spending limits, it is critical to uniquely identify physicians across multiple input sources and accurately report on the results. To meet this challenge, pharmaceutical and biotech companies need to overcome the following Data Challenges:

Data Challenge Required Capability HMS Compliance Solutions™
Reference Data
Challenge
A complete master file of all physicians HMS MasterFile
Provider Matching
Challenge
The ability to link the same physician across multiple systems HMS Data Integration Services
Data Maintenance
Challenge
The ability to continuously maintain accurate customer databases Web Services
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The Answer: HMS Compliance Solutions™

As part of any state compliance strategy, a new approach is required that allows organizations to overcome the reference data, provider matching, and data maintenance challenge created by new state regulations. Customers using HMS Compliance Solutions™ are able to:

  • Build a Single View of Practitioner Spend
  • Integrate Disparate Systems
  • Create A Trusted Compliance Customer Master

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Key product features:

  • Avoid fines
  • Protect your reputation
  • Save time

Ideal For: