Provider Data Dorks

CertifyOS
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Provider Data Dorks is the podcast for anyone who works with, buys, or builds on provider data. Hosted by Nick Helfrich and Mitch Gorodokin, each episode features the leaders who understand healthcare's most complex invisible problem and are working to fix it. From payer directories to credentialing to interoperability, we get into the real issues, with the people closest to them.

Tập

  1. 1 ngày trước

    How This Founder Exposed Healthcare's Most Broken Provider Data (and Why It Matters) with Ron Urwongse

    Finding an in-network doctor shouldn't take twenty phone calls. But provider directories (the invisible backbone of healthcare) are wrong so often that the best payers in the country top out at 70% accuracy, and the worst sit at 30%. Most people assume that gap is a mystery. Ron Urwongse proved it's measurable. Ron is the co-founder of Defacto Health and former innovation and strategy lead at CAQH. When CMS mandated that insurers publish their provider directory data through public APIs, he did something almost nobody else did: he read them. All 150 of them. By aggregating those feeds and scoring where payers agree and disagree, Defacto turned one of healthcare's messiest problems into something you can actually put a number on. In this conversation with hosts Nick Helfrich and Mitch Gorodokin, Ron breaks down why cleaning data upstream beats patching it downstream, why "single source of truth" might not save us, and the surprisingly human reasons good directories go bad. Why payer directory accuracy ranges from 30% to 70% and what separates the twoHow consensus scoring across 150 payers reveals which addresses are actually rightThe dropdown-menu mistake quietly generating thousands of directory errorsWhy health systems often hold better data than the payers publishing itWhat the No Surprises Act, MA Plan Finder, and Real Health Providers Act mean for youHow Defacto audits insurers using nothing but the data those insurers publishRon's rule for building anything that lasts: fall in love with the problem Subscribe to Provider Data Dorks for the people fixing healthcare's hardest data problem. New episodes weekly on YouTube, Spotify, and Apple Podcasts.

    41 phút

  2. 9 thg 6

    How a Former $10B Hospital CEO Would Fix Provider Data if He Started Today | Steve Klasko

    Steve Klasko was a DJ named Little Stevie Kent who got into medical school partly because an admissions officer recognized his voice from the radio. He then spent 40 years proving that listening (really listening) separates transformational leaders from the ones who just manage decline. As CEO of Jefferson Health, he took a $1.5 billion system to $10 billion in nine years, fought the FTC, and made enemies in every insurance boardroom in Philadelphia. His method was simple: stop asking lawyers what you're allowed to do. Tell them what you're going to do, and ask them how to defend that action. In this episode: Why Jefferson was "a place where good ideas go to die" and how Klasko changed that by deciding the lawyers worked for him, not the other way aroundThe credentialing nightmare hiding inside every hospital M&A deal, and what those three months of lost revenue actually costWhy healthcare is 15 years behind finance: "We select doctors for organic chemistry grades. Then we're amazed they aren't more empathetic."The MRI pricing story: Klasko called six facilities, asked a simple question, and the last one hung up on himHow defragmenting a hard drive became his mental model for fixing broken provider data infrastructureHis vision for 2031: patients own their data, credentialing happens in milliseconds, and the whole apparatus is a commodityHis one wish for healthcare, told through a Jason Kidd quote about turning things around 360 degreesFollow Provider Data Dorks on Spotify and Apple Podcasts for weekly conversations with the leaders who built the system and the ones rebuilding it. New episodes every Wednesday.

    1 giờ 2 phút

  3. 2 thg 6

    Why Shared Credentialing Has Failed Every Time (and Why It's Different Now) | Tyler Ford

    Provider data has been called the invisible backbone of healthcare. It drives directories, network adequacy, credentialing, claims… basically everything. And in most organizations, it's still managed through spreadsheets, siloed systems, and a stack of vendors that don't talk to each other. So why hasn't the industry fixed it? Tyler Ford has spent his career at the center of that question, from the Advisory Board to UnitedHealth Group to his current role as SVP of Strategy and Operations at Union Healthcare Insight. He's one of the few people who has seen this problem from every angle: the plan side, the regulatory side, and the advisory side. And in this conversation, he doesn't pull punches. What's covered in the first episode of Provider Data Dorks with Tyler Ford: Why provider data is a definitions problem, a technology problem, and an incentives problem all at once and why that intersection is what makes it so hard to solveThe credentialing standoff: health plans need accuracy and compliance; providers need speed. Why bridging those two priorities has never workedThe one provider data standard that actually succeeded (the CRED App), why it worked, and the lesson the industry hasn't learned from itWhy standards without enforcement are just suggestions and what No Surprises Act implementation taught the industry about accountabilityWhat Tyler calls the "Gordian knot" problem: why shared credentialing isn't one solvable problem but a system of layered complexity in technology, incentives, process, and peopleThe five pillars of CertifyOS's shared credentialing model and why Tyler thinks the conditions to finally make it work are actually hereWhy the shift toward consumer-driven health plans (ICHRA/ECS) is about to make clean provider data mission-critical for health plan survival Subscribe to the show on YouTube, Spotify, and Apple Podcasts, or wherever you get your podcasts.

    49 phút
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Giới Thiệu

Provider Data Dorks is the podcast for anyone who works with, buys, or builds on provider data. Hosted by Nick Helfrich and Mitch Gorodokin, each episode features the leaders who understand healthcare's most complex invisible problem and are working to fix it. From payer directories to credentialing to interoperability, we get into the real issues, with the people closest to them.

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  • Nhà sáng tạo
    CertifyOS
  • Năm hoạt động
    2 N
  • Tập
    3
  • Xếp hạng
    Sạch
  • Bản quyền
    © CertifyOS
  • Trang web chương trình
    Provider Data Dorks

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