Provider data management (PDM)
Provider data management (PDM) is the work of collecting, checking, keeping current and sharing information about healthcare providers across an organization's systems, from the member directory to claims, credentialing, referrals and network reports.
What does provider data management cover?
A health plan or health system holds provider information in many places: the online directory, the claims system, credentialing files, contracting records and referral tools. PDM is the process, and the software, that keeps one accurate version of each provider and sends it to every system that needs it.
How is PDM usually done?
Traditionally, by collecting what providers report: roster spreadsheets from groups, attestations through portals like CAQH, and calls from staff. Newer approaches check that information against outside evidence, such as claims activity, licensing boards and practice websites, and score how likely each field is to be right.
Why does it matter?
Wrong provider data sends members to doctors who have moved or left the network, puts plans at risk under directory accuracy rules, and makes network adequacy reports unreliable. The CAQH and AMA white paper on provider directories describes how much of this work falls on provider offices.