Provider Directory Automation

Self-Funded Employers Network Management Firm

Business Problem

  • 10k~ records directory processing was completely manual – no scalability
  • New provider additions were identified using excel & entered one by one through an application UI
  • Significant data quality issues on provider directory due to lack of validation logic
  • “Changed” and “Terminated” providers were not processed at all
  • Member facing provider directory was inaccurate and out of date

The solution


The results

Prior to automation, 10k~ row file was manually processed monthly

  • Manual processing excluded updated records (e.g., changed addresses and phone #s)
  • Manual processing excluded terminated records (e.g., providers that left the network)
  • Manual processing prone to data entry errors for 1000s of new record additions

After automation

  • 1 FTE of work saved monthly through automation
  • All updates, terminations, additions automatically updated in Provider database
  • Address discrepancies resolved using Google APIs
  • Metrics produced to automatically track monthly updates
Reduction in processing time
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