Healthcare

Provider management

Keep provider directories current and compliant with AI agents, that validates and propagates updates in real time.

Capabilities

Self-service directory management

Enable providers to update addresses, panel status, specialties, and credentialing documents with AI agents

Secure access

Provider identity verification

Verify provider NPI/TIN before any profile update workflow is initiated, ensuring only authorized representatives can submit changes.

Update category

Update type classification

Identify the update category across all supported types: address, panel status, telephone, office hours, specialties, provider terminations, licensing, and credentialing documents.

Document processing

Credentialing document intake

Extract, classify, and match licensing and credentialing documents to the provider profile, with expiry tracking and re-verification alerts built in.

Validated at entry

Real-time data validation

Cross-check submitted data against licensing boards, NPI registry, and state agencies before applying any change, preventing inaccurate records from entering the directory.

System-wide update

Directory sync & propagation

Push approved updates across payer systems and member channels in real time, so no listing stays stale.

CMS compliant

Audit trail & compliance log

Log every update with provider identity, change type, validation result, and timestamp to meet CMS and NCQA mandates.

Outcomes

Stay compliant, cut manual overhead

Meet CMS mandates and eliminate manual update rework with AI-driven provider data management.

30 days

CMS directory update mandate met automatically

80-90%

lower data transcription time

Related use cases

Continue building the payer operations picture

Ready to  automate provider data management?

See how Kore.ai keeps provider directories accurate, compliant, and current without manual update overhead.