Home Forums Discussions General Discussion Enclarity - has anyone heard of this organization

I received a fax from 'Enclarity' that is requesting me to verify practice information for pharmacy refill requests.
I have never heard of this organization.
Has anyone heard of this organization?

I received faxes from them and then looked them up. They are verifying information. I should have requested payment for use of my information, since they are selling data, but I did not

Try this link https://www.enclarity.com/providerfaqs.php

I don't respond to their requests for info. I just delete the faxes

we've done the same

thanks for feedback

I received a request recently
thought they were legit.
bala

They just vacuum up public info about us and sell it to whoever will pay them. They want us to verify their busy work for free. Don't help them. You will just loose the floodgates of "medi-spam".

In one sense, they probably are "legit". They are likely above-board in collecting assorted information (credentialing, etc) and selling it to other legitimate companies that have a legal need for it.
On the other hand, as John points out, they are part of a very profitable HIT sector that buys and sells information about us, to the benefit of everyone except us.
Ask anyone 10 years old and up and they will tell you: if an unsolicited person asks you for information in an email or online, don't give them your name, address, SS#, etc, etc. It is likely spam, phishing, or worse. Somehow in healthcare we have grown so accustomed to handing out this information that we may produce it too willingly or without some compensation. If part of your contract with an insurance company says that you will freely provide this information to their designated go-between (like Enclarity) then you may have to do so. Otherwise, tell them "no thanks" or if you choose, quote a price of what it will cost them to get the information. Just my two cents.

They sound legit to me, too. The information they have on me is all public knowledge, so I confirmed it and faxed it back. I would rather do that than put up with all the MISinformation about me that is out there on the web. Some of those doctor rating sites say that I am a pediatrician or give practice sites that I left years ago, and never ask me if any of it is correct.

Most insurance companies will use CAQH to verify credentialing information about you, including your office address, phone and fax numbers, dea, etc. So there really is no need to provide this information to companies like Enclarity unless they pay you $500 for it.

Enclarity is definitely legit and, as another poster mentioned, their business is to make money off of correct provider info. The ongoing issue with using CAQH or other credentialing info though is that it's not updated enough. It's pretty uncommon for many providers to notify their credentialing organization when moving/changing practice addresses, phone numbers or office hours which is what creates the market for Enclarity. So it might be correct every 2-3 years...but that's it. Plus there is a huge disconnect between an insurance companies credentialing staff and, say, their directory or consumer facing group. They often don't share too much with each other...in our experience.

Our organization helps a few large insurance companies produce provider directories by verifying and standardizing the info because of what I mention above. NPI was supposed to help but hardly anyone updates their NPI records (plus you can only have 1 office address, etc.).

Faxing is a little old school but I'd love to find a way to resolve the outdated info.

I would assume that you are responding from Enclarity, although the first paragraph you state "their" and the second you use "our" but the third you discuss faxing.

The way to solve the problem is Money. The world goes around by money. Insurance companies make money off of us, you make money by selling our information. Our rates are getting less but everything else is going up. WHY SHOULD WE COOPERATE WITH A SYSTEM THAT ABUSES US!

Sorry about screaming but you will get little sympathy from physicians about a saprophytic system.

We would love to resolve a way to make more money.

Wendell,
Don't apologize for screaming; I found you to be rather restrained. In particular, you were kind to say "saprophytic" (as opposed to "parasitic"). It would appear that Mr. Healthdetail works for another company, one in competition with Enclarity (it's called Healthdetail). More upfront acknowledgement of this might have been nice, though it is obvious from his profile. The two companies do the same thing, and make their money the same way. In fact, they both do what CAQH does. The difference? CAQH is a non-profit alliance; hence his attempt to denigrate CAQH's value. We have found CAQH to be rather helpful in reducing the incessant requests for information by the numerous insurance companies. They do however ask that you regularly go online and "re-attest" to the accuracy of your information, in direct contradiction to the claim by Mr. Healthdetail that their information is not updated often enough. I wonder how his company deals with this issue; I would assume that they contact you even more frequently, demanding that you verify your information, then charging others to provide your information.

Yes, thank you JBS. We were not trying to hide anything and have zero affiliation with Enclarity, we just know they exist by seeing their website over the years and news stories. In the 2nd paragraph of our initial response I did mention a service we provide to verify provider information. As JBS mentions, we are upfront with the profile. The only reason to make a comment here was to solicit input and follow the thoughts of the provider community on this topic. There are other discussion boards re: Enclarity's faxes which we have also followed.

Enclarity is much bigger and is attempting to be a FICO (credit scoring) type of service for healthcare information.

As far as CAQH and its service, if it appeared as if I was denigrating them in the initial response, then that was incorrect. This user account is for HealthDetail, but I can tell you that I spent 5 years working at one of the Top 3 (in size) insurers in the country for 5 years. The credentialing and consumer facing provider information (online/print directories, customer servicing, provider assignment) were completely different departments. Even if the credentialing dept got updated information on a provider, it wasn't shared. This is not uncommon because the credentialing dept sees its job as more related to compliance, which is accurate, vs. customer service...which might be where the directories are. No, it might not make sense, but it's the reality and certainly helps with the inefficiencies in healthcare. A providers credentials come from credentialing, but not the demographic info, hours, etc.

Instead of CAQH lets look at NPIs. The agreement with CMS says that each provider is to update changes to his NPI record within 30 days of the change. We can tell you from reviewing this file each month that it's not at all close to being done. How many viewing this thread have changed their NPI info (phone, billing address, practice address, licensures, taxonomy codes) since receiving their NPI? Very few, we know. In theory, that should operate similar to CAQH. And there is no membership for CMS/NPI.

I have no reason to defend Enclarity, or us, for verifying provider information and I think, in this case, anger at this practice is misdirected. There are definitely areas that companies make money "off the backs" of providers, Rx is a great example. But having a process to try to cleanse or fix incorrect info, is completely different. An earlier poster said he was "tired of seeing incorrect information" online about his practice and sent the info back. That is the purpose of this service. If CAQH can pull off being a trusted source of provider information, great, but hasn't fully happened so far. If so, CMS would use their info instead of requiring NPI updates directly.

One more example is that 2 years ago CMS contacted us to help maintain the Medicare.gov website. They recognized lots of info was incorrect and needed help keeping it up to date. (They later shelved the project.) If CMS has trouble with this...

No, we (HealthDetail) don't contact people more frequently. Both companies try to start with public sources, but when you have a conflict you have to figure which is correct. As stated earlier, if there are better options (pay is one) then would be interested in seeing. But I'm not sure paying Bob Jones to confirm that Dr. Robert G Jones is at 123 Main St is practical. From an insurers prospective, if the info is incorrect then Dr Jones may not get as many new patients so he already has a vested interest in making sure the info is accurate.

Darrell (for HealthDetail)

The presumed basis for Enclarity and Healthdetail is to provide updated information to the insurance industry and to local and mail order pharmacies so that they have the most up to date contact information for our practices. That's great, provided that saves us from having to contact or to receive an inquiry from each individaul entity and is at no expense to our practices.

The PROBLEM, however, is that they sell our information to everyone else trying to make a buck off of our practices by getting us to subscribe to needless services, to buy products which we are not interested in or to prescribe drugs that we do not necessarily care to prescribe. The net result is repeatedly receiving unsolicited faxes, e-mails and phone calls.

If Enclarity and Healthdetail would provide our information ONLY to those entities with winch we have a contractual relationship or for those to which we would be allowed to opt-in, it would be great. The fax that I received from Enclarity, however, seemed to indicate that they would provide my information to whomever they pleased, not to whom I would like it to go.


Bob