HIMSSCast: A single source of truth for provider data nationwide
CertifyOS founder and CEO Anshul Rathi engineered a database of providers for payers.
Photo: Tetra/Getty Images
Anshul Rathi, founder and CEO of CertifyOS is an engineer by background who became one of Oscar Health's earliest employees, working to build their provider network management function.
This is for payers, who are responsible for supplying members with the directories of providers within their network and also doing thorough background checks.
"That's where I realized there is no single source of truth for provider data," Rathi said.
Six years later he founded CertifyOS and decided to "engineer the problem" for frictionless provider data and also for workflow automation for credentialing and licensing.
Rathi's vision is no less than to create provider data infrastructure for the healthcare industry in the United States.
For more on the business model, listen to his conversation with Susan Morse, executive editor at Healthcare Finance News.
Talking points:
- CertifyOS specializes in healthcare provider credentialing and licensing.
- An API-first approach captures data to reduce provider onboarding time and avoid 40-page application forms.
- Despite strides, 58% of applications for in-network status are still handwritten.
- The digital approach represents 40% in cost savings to payers.
- It is primary source verification for background checks on providers.
- CertifyOS started two years ago and has grown to 90 customers.
- It has information on four million practitioners in the United States.
More About this Episode:
Humana taps Veda to improve accuracy of provider directories
CMS seeks comment on first healthcare provider directory
To meet interoperability mandates, providers and payers should build API expertise
Most vendors now using APIs to expand EHR functionality, says ONC
Health plan provider directory data should be updated monthly for the patient's sake
Email the writer: SMorse@himss.org
