The CarePrecise Reference Database of U.S. Healthcare Providers

Merging the Healthcare Provider Data Silos

Our company's founders began developing cutting-edge record-linking, deduplication and deflation technology in the early 1990s. The current state-of-the-art makes it possible to offer data products representing billions of data points linked from multiple sources, for use on ordinary laptop and desktop computers in standard database software.

QoRelate™ Record-Linkage Platform version 7.5

Assimilating and cleansing data from multiple sources is a mounting challenge. CarePrecise offers you an advanced solution for a trusted master record in today's environment of escalating regulatory requirements. Marrying your data with officially disseminated federal records on all HIPAA-covered healthcare providers boosts efficiencies and helps bring risks within tolerance. Developing a master file that brings so much up-to-date information together is frequently outside the core competencies—and budgets—of most organizations.

We invite you to compare our pricing and products with other solutions. CarePrecise is dedicated to offering the best products and the best value, and we've been hitting the mark since 2007.

Trusted Data from Authoritative Sources

Our goal is to continue adding key data points to our healthcare provider data reference, of which CarePrecise Platinum is a primary part, from new sources as they become available. Through filings of FOIA/FOIL requests and advocating for open information, this data is gradually becoming more and more available. But each source has its own format, its own coding methodology, and few if any common unique identifier fields by which to cross-match records between sources. For example, the unique identifier code for hospitals is the CCN (CMS Certification Number), but much information for these facilities is to be found in other datasets that do not reference the CCN, such as the NPI Registry. A CCN-to-NPI number crosswalk is an exceptionally valuable asset.

Linking records without unique identifiers

Let us introduce you to QoRelate™, our proprietary data "shrinking and linking" technology, that we use to embrace each new data resource that comes available. Currently, we are working with the National Plan & Provider Enumeration System (NPPES) The Centers for Medicare and Medicaid Services (CMS) maintains this database. All healthcare providers who are HIPAA covered entities must obtain a National Provider Identifier (NPI) by reporting their information via the NPPES, and updating it when it changes. This represents virtually all of U.S. physicians, hospitals, and other providers who accept insurance or are associated with a hospital. —the official federal NPI registry—updated monthly by the Centers for Medicare and Medicaid Services, the  PECOS The federal database containing information on healthcare providers who are eligible to bill Medicare (Provider Enrollment, Chain and Ownership System). (Medicare provider enrollment database), the federal List of Excluded Individuals/Entities (LEIE), List of Excluded Individuals/Entities (LEIE): The federal database maintained by the HHS Office of Inspector General containing information on providers who have been barred from billing Medicare due to fraud or controlled substance conviction, patient neglect or abuse, and other reasons. CarePrecise uses a proprietary record-linking system to attach active NPI numbers. demographic databases from the U.S. Department of Commerce, a panoply of data sets maintained by Medicare, and other free and fee-based sources, and are working to add many others. CarePrecise can offer a single database, keyed on the NPI number, combining providers' PECOS, NPPES, and LEIE data. Data is updated real-time, as federal sources release it, and distributed to our subscribers each month, in formats ready for immediate use within Microsoft Office applications, and for import into in-house systems.

Using QoRelate, we bring provider information all within this centralized framework, linked by the unique NPI number assigned by the federal government to each HIPAA-covered entity (about 7.4 million healthcare providers, both individuals and organizations). PECOS status and exclusion status from the LEIE are part of every CarePrecise NPI-keyed record.

New with version 7.5 released November 5, 2021, is a new methodology for matching records that have only name and address common fields, using advanced data conformation and new linkage loops, resulting in near-perfect positive linkage, and near zero false negatives.*

CarePrecise can also provide Placekey and SelectGeo latitude and longitude appending - remarkably useful in merging records and determining geographic densities of medical services.

The Healthcare Provider Data

Our database of more than 10 million provider records is updated monthly, and is the most comprehensive and accurate healthcare provider data available anywhere. More than 200,000 edits are made to this dynamic database each month.

Specific data fields included in CarePrecise healthcare data solutions are detailed in our online help pages. The data is provided open source without restriction on the number of uses or exported records by the license holder, although derivative products and redistribution are prohibited without the purchase of a special license.

The CarePrecise Complete database includes all U.S. healthcare providers that are covered entities under HIPAA, representing nearly the entire universe of providers in most categories (physicians of all specialties and subspecialties, hospitals, dentists, physician assistants, advanced practice nurses, clinics, labs, pharmacies, etc.). HIPAA covered entities are required by law to report to the National Plan & Provider Enumeration System database to obtain a National Provider Identifier (NPI) number. Enumeration is required in order to bill Medicare, write prescriptions, file electronic health insurance claims, or be listed as a referring provider on any other provider's electronic health insurance claim, or who have an affiliation with a hospital or other entity that files insurance claims. No provider may opt-out of this database or its distribution, and all are required to update their information when it changes. (Some sensitive data such as SSN and DOB is, of course, redacted.) There is also a strong economic incentive for providers to keep their data current, as these source databases and CarePrecise products are used throughout the healthcare industry to expedite Medicare and private health insurance claims processing and to assure proper reimbursement.

In addition to collection and linking, QoRelate can selectively cleanse the data, making sense of some of the more cryptic codes, and conforming mistyped entries to standard codes, as well as eliminating duplicated data existing in multiple source databases to make it easy to use in a typical office computing environment. These techniques incorporate other provider data in a similar manner, making it possible to bring in deeper data, as in our CarePrecise Advanced Dataset, the Authoritative Hospital Database, and the Authoritative Physician Database. The CarePrecise family of provider data products aims to be a single-source of truth on U.S. healthcare providers.

Custom Record Enhancement Services: Customer Data Integration

QoRelate and the CarePrecise Reference Database (CPRD) with its master data management (MDM) structure form the basis of our ability to enhance our customers' in-house data. Using our data matching system, we can input a client's database, match it to our reference records, and send the client vastly enriched information.

Because we work exclusively within the healthcare domain, our system is optimized for linking healthcare records, and is the most advanced such system available. Contact us for pricing and additional information.

Private Record Linkage Services

As a third party vendor, CarePrecise offers record linkage services to organizations who may not wish to share all of their list data with a partner organization, but who need to identify the intersecting set of records for various reasons. Mergers and acquisitions, healthcare information exchanges (HIE), and list-share agreements are among the applications of private record linkage services. Each project is unique and presents special challenges; contact us for pricing and additional information.

About Accuracy

No record-linkage system can promise 100% match accuracy (unless 100% accurate common unique identifiers (CUI) are present in each data source). Where no CUI is available across all sources, record linkage processing must account for thousands, even millions, of variables, depending on the specific project. Match accuracy is measured in terms of false positives (the system claiming a match that is not really a match) and false negatives (the system failing to catch a match). Understandably, reducing false positives is the priority, since it is better to have no match than to falsely attribute a provider's records. The accuracy of the base data affects the ultimate usefulness and accuracy of matches, but QoRelate standardizes the many different ways that a practice address or company name may have been entered. Read more about healthcare provider data accuracy...

Putting the Linkage in Your Hands

Our exclusive CoLoCode® – created by QoRelate and included with most CarePrecise products – allows the user to connect providers by practice location. This powerful tool can be used in many ways to sharpen the picture of U.S. healthcare resources, and can be used in any relational database software. CoLoCodes are present in all CarePrecise data products, compared here.