Getting a payer file is easy. Trusting it is not. In a late-2025 survey of 56 hospital and health system C-suite leaders, 87% said claims data matters to value-based care. Only 35% were confident it was accurate. Just 11% called their data setup excellent.
A file can arrive on time, load cleanly and still be wrong. Codes change. Patients drop off the list. Records go missing. None of it stops the data from reaching dashboards, provider scorecards and the call lists care teams use. Someone catches it by questioning a number that looks off, long after decisions were made.
One health system brought this work in-house to save money. A coding mistake tied one family member’s prescriptions to everyone on the policy. Staff called patients about drugs they had never taken. Fixing it cost $250,000.
This whitepaper covers the work that starts after the first file lands, what it costs in-house, and who should own it.
Inside the guide:
- Nine jobs that repeat every cycle, from chasing missing files to fixing errors and getting clean data where it belongs
- Why 45% of organizations needed five months or more to add one new payer, and 89% say file formats keep changing
- How eight payer contracts turn into 40 or more files a month