26 items tagged ”Healthcare”

Improve healthcare provider data accuracy and compliance to reduce risk, ensure regulatory alignment, and streamline operations.

<p><i>Part two of our </i><a href="https://www. smarty. com/content/tags/provider-data-accuracy-series"><i>provider data series</i></a><i> featuring thought leadership from Dave Medlock, Founder &amp; CEO of Maven One Health</i></p><p>If you’ve ever searched your health plan’s provider directory only to find your “nearby” doctor is actually a residential home—or worse, a PO Box—you’ve experienced firsthand why clean provider data matters for more than just compliance. </p><p>Provider data accuracy is also one of the most important aspects contributing to member experience.

<p><i>The benefits of reliable, easy-to-implement address data are straightforward. Actual addresses, on the other hand, aren’t always so cut and dry. </i></p><p><i>If you’re looking to become an expert in everything that begins or ends with an address, this series is for you. We’ll demystify the types of addresses that have developers scratching their heads and introduce you to the tools keeping your address data best-in-class. </i></p><p><i>Come one, come all, and enter the wonderful world of peculiar addresses! Let’s see what’s on exhibit.

<p>Welcome to part one of our <a href="https://www. smarty. com/content/tags/provider-data-accuracy-series" target="blank" rel="noopener">new blog series</a> on provider location data—an exploration into the messy, high-stakes world of healthcare compliance, address accuracy, and network adequacy. </p><p>To kick things off, we sat down with Dave Medlock, founder of<a href="https://mavenonehealth. com" target="blank" rel="noopener nofollow"> <u>Maven One Health</u></a> and a contributing thought leader, to discuss why clean provider data is essential for achieving peak regulatory compliance and meeting requirements with ease, thereby avoiding serious consequences if it isn’t done correctly.

<p>Once you know what capabilities you need, the next challenge is choosing a provider that actually delivers—pun intended. <br><br>This blog is part of our <a href="https://www. smarty. com/blog/tags/what-to-look-for-in-an-address-data-solution">five-part series, <i>What to look for in an address data solution</i></a><i>. </i> </p><p>Previously, we discussed the need to find an address data solution that understands the importance of speed, scalability, and reliability, enabling you to maintain automated, efficient, and accurate workflows in any industry that deals with addresses.

<p>Address data plays a vital role for finance, healthcare, and insurance companies. When these companies serve customers worldwide, processes like KYC compliance, fraud prevention, and onboarding become even more complicated, making accurate data even more essential. </p><p>Enter <a href="https://www. smarty. com/products/international-address-autocomplete"><u>International Address Autocomplete</u></a>, a form and checkout address-filling feature that saves the day for more than just ecommerce companies based in the US.

<p>If data is the lifeblood of your business, addresses are the veins that carry it. They connect every operation—from shipping to customer service to compliance. </p><p>Yet, address data is often overlooked until it breaks something expensive. </p><p>This post kicks off <a href="https://www. smarty. com/blog/tags/what-to-look-for-in-an-address-data-solution">our five-part series, <i>What to look for in an address data solution</i></a>—a practical guide to building a smarter, cleaner, and more reliable address data strategy.

<p>Your product might be HIPAA and ACA-compliant in theory, but a mistyped ZIP Code or invalid apartment number can still trigger privacy violations, eligibility errors, and failed mailings. Misdirected mail is explicitly named in HIPAA breach cases. </p><p>For example, the Health and Human Services (HHS) Office for Civil Rights (OCR) has publicly cited misrouted or misaddressed mail as a cause of HIPAA breaches in their <a href="https://ocrportal. hhs. gov/ocr/breach/breachreport. jsf" target="blank" rel="noopener"><u>breach portal</u></a>.

<p>You finally track down an essential addition to your collector’s set of [insert item of your choice], and you're hyped to buy it until the chaos begins. </p><p>The cart is hidden in a fly-out on the side, cluttered with blocky, overwhelming text. You spend way too long just trying to find the "Proceed to Checkout" button. </p><p>👎 That’s bad UI (user interface): messy, confusing design that makes navigation a chore. </p><p>You make it to the checkout and start entering your info, but the site keeps rejecting your address.

<p>International healthcare is complex. Inaccurate or unverifiable international addresses make it worse by delaying claims, increasing compliance risk, opening the door to fraud, and frustrating members. </p><p>Healthcare companies need global healthcare address verification that’s scalable. Here's how to get there. </p><h2>Why global address verification is especially complex for healthcare companies</h2><p>Healthcare depends on addresses. While just one datapoint, addresses are foundational to so many critical healthcare management processes and vital to get correct.

<p>When it comes to address verification, getting a match every time might <i>seem</i> like the goal. After all, a system that always returns a validated address must be working perfectly, right?</p><p>Wrong. </p><p>If your address verification API <i>always</i> forces a match, no matter what, it’s not being helpful. It’s actually introducing risk. In fact, getting a “no match” result can frequently be the smarter, safer outcome. </p><p>Let’s talk about why. </p><h2>What is a "no match" telling you?</h2><p>A “no match” means the input address doesn’t align with any known, valid address in the reference database.

<p>Healthcare fraud isn’t just an occasional headache—it’s a <a href="https://www. pymnts. com/identity-theft/2022/synthetic-identity-fraud-costs-businesses-billions-each-year-data-shows" target="blank" rel="noopener"><u>$20 billion-a-year black hole</u></a> draining financial institutions. </p><p>And that’s just the fraud we know about. </p><p>As healthcare systems become more complex, fraudsters are also getting smarter, faster, and more creative at exploiting vulnerabilities, especially in address verification.

<p>Let's start with a number that should make every hospital administrator do a double take: $17. 4 million. That’s how much the average hospital loses annually—just from denied claims due to patient misidentification. This isn’t from equipment costs, not from staffing shortages, and not even from insurance negotiations—just from keeping bad patient data. </p><p><i>Surely, our forms aren’t that bad. (Yes, they are, and stop calling me Shirley. )</i></p><p>But here’s the reality: According to the <a href="https://security.

<p>Healthcare is experiencing a dramatic shift in how patient information is stored and managed. Electronic medical records (EMRs) and electronic health records (EHRs) have become the new standard, driven by two powerful forces: everyone has mobile devices and the increase in the human population. </p><h2>A growing problem with clean address data in EMRs and EHRs</h2><p>While EMRs and EHRs offer amazing accessibility and storage capabilities (way better than a filing cabinet), they've also exposed a critical weakness in many healthcare organizations: address data quality.

<p>In any industry that’s regulated and works with PII (personally identifiable information), a simple address error can cost more than just a returned letter. With HIPAA violations ranging from $100 to $50,000 per incident and the possibility of criminal charges, getting patient addresses wrong is more than an administrative headache—it's a serious compliance risk under HIPAA, ACA, and other mailing regulations. </p><p><a href="/ebooks"><u>Our new ebook</u></a> explores how address data quality directly impacts regulatory compliance, patient privacy, and health equity requirements, among 12 other hot topics.

<p><a href="/solutions/healthcare">In healthcare,</a> the havoc an inaccurate address can wreak on your financial results is significant in more ways than one, and the boost in overall profitability from maintaining a clean address database is equally worth noting. </p><p>Accurate <a href="/products/us-address-verification">healthcare address validation</a> improves operational efficiency, patient engagement, and compliance and builds revenue to heights that couldn’t be met without it. </p><p>Here’s what we’ll be covering:</p><ul><li>Healthcare address validation pros and cons<ul><li>Con: Increased claim denials and organizational costs</li><li>Pro: Reduced claim denials and reprocessing costs</li><li>Con: Increasing patient match error rates</li><li>Pro: Improved patient matching and data quality</li><li>Con: Complicated billing and collections processes</li><li>Pro: Streamlined billing and collections capabilities</li><li>Con: Exposure to legal liabilities</li><li>Pro: Enhanced regulatory compliance and risk aversion</li><li>Con: Misplaced market strategy</li><li>Pro: Data-driven decision-making and market insights</li></ul></li><li>Epilogue: Avoiding the pain (see our summarized financial savings)</li></ul><h2>Healthcare address validation pros and cons</h2><p>There’s a pro and a con associated with having (or not having 🫣) accurate address data in your healthcare systems.

<p>We had a sit-down with Smarty crew members, Caroline Roweton, Associate Product Manager, and Landon Fackrell, Software Engineer, and delved into Smarty's innovative new <a href="/articles/batch-address-validation-geocoding-excel">Excel plugin</a>. </p><p>This powerful tool makes address validation easier than ever, allowing users to clean and verify their address data directly within Excel. With a focus on simplicity and efficiency, Caroline and Landon talked about the features and benefits of the plugin, demonstrating how it can save time and enhance data accuracy without any need for coding.

<p>PROVO, Utah, April 10, 2024 – <a href="/">Smarty</a>, the address data intelligence leader, announces today the launch of US Census Block and Tract Data, a set of updates to Smarty's US Address Enrichment solutions. US Census Block and Tract Data is a cloud-native solution that will allow organizations to append the geographic data found in U. S. Census Block and Tract information into accurately geocoded addresses. </p><p>Smarty’s US Census Block and Tract Data offers a simple and rapid solution for accessing essential geographic details such as Census Blocks, Tracts, location names, statuses, and additional Census ID information—mirroring the capabilities of the <a href="/articles/ffiec-geocoding">FFIEC Geocode</a> tool.

<p>In a recent webinar, Berk Charlton, Chief Product Officer at Smarty™, provided an in-depth look at our industry-leading address intelligence suite designed to provide highly accurate geocoding and address validation. </p><p>Here are the main points Berk covered during the session:</p><blockquote><p><strong>Comprehensive product suite</strong>: Smarty offers a wide range of products, including <a href="/products/us-address-verification">address validation</a>, <a href="/products/us-rooftop-geocoding">rooftop geocoding</a>, <a href="/products/international-address-autocomplete">global address auto-complete</a>, and <a href="/products/us-property-data">address data enrichment</a>.

<p>Smarty™ recently hosted an enlightening webinar on Project US@, a vital initiative in health information technology. The webinar, led by Wes Arnold, Team Lead of Product Marketing, provided insights into Project US@ and its significant role in patient data management. </p><h3>What is Project US@?</h3><p>Project US@ is led by the Office of the National Coordinator for Health Information Technology in collaboration with HSC and AHIMA. The final version 1. 0 was released on January 7, 2022. </p><p>The goal? The initiative's main objective is to establish a standard approach for representing patient addresses across all health IT systems.

<p>In our previous post, we prescribed solutions to the problems associated with having bad address data in the software side of healthcare. If you would like to go over those again, or if you stumbled upon Post 3 before the previous blogs, you can read <a href="/blog/address-affairs-causing-healthcare-hiccups">Post 1</a> or <a href="/blog/healthcare-hiccups-and-address-solutions">Post 2</a> now. </p><p>In this third and final installment, we hope to provide even more solutions to healthcare hiccups on the SaaS side.

<h3>Software in the healthcare industry</h3><p>In our <a href="https://www. smarty. com/blog/address-affairs-causing-healthcare-hiccups">previous post</a>, we diagnosed the problems associated with having bad address data in the world of healthcare. If you would like to go over those again, or if you stumbled upon Post 2 before Post 1, you can read about those problems here. </p><p>In this second installment, you'll learn about the solutions to those problems from a software development standpoint.

<h3>Why accurate addresses matter to healthcare professionals</h3><p>The healthcare system typically relies on human entry for its data entry. Whether the information is added by the customer, a receptionist, a nurse, or even a doctor, there are a lot of areas for the information to be misentered. Not only that, but hospital staff members frequently edit or enter additional information following the patient's first visit. The constant editing and entering of data by a human results in more than just a tiny typo now and again.

<p>Handling address data is such a routine occurrence for health insurance providers that it’s not the first thing that would come to mind as being a liability. However, the reality is that discrepancies and inaccuracies in address data can have far-reaching consequences, posing serious privacy and compliance risks. Healthcare fraud, reputational damage, and financial penalties are just a few examples of the potential hazards. </p><p>In this blog, we’ll delve into three common types of privacy and compliance risks resulting from incorrect or incomplete address data.

<p>When it comes to physical health, sometimes the smallest things can have a big impact. A microscopic virus or a small injury can develop into a life-threatening infection before you even know it’s there — and conversely, a tiny pill or ointment can save a life. </p><p>The little things matter when it comes to health data, too. In particular, address data is a small part of a patient profile that can have far-reaching effects if it is incorrect or incomplete. Address data is a key information point at the center of billing and communication with patients, and even a slight mistake in an address—a missing unit number or a misspelled street name—can make mail undeliverable.

<p>Ever since the <a href="https://www. healthmarkets. com/resources/health-insurance/american-healthcare-history/"><u>first Blue Cross health insurance plan</u></a> was provided to Texas schoolteachers in 1929 for a monthly fee of $6, health insurance providers have formed the backbone of the American healthcare system. </p><p>Today, as that system faces ongoing scrutiny, health insurance providers are still at the heart of the action, striving to connect patients to the highest possible quality of care while navigating significant changes including rising costs, digital transformation, medical advances, customer expectations, and ever-present regulations.