Ribbon launches TINs, unlocking new understanding of complex relationships and improving provider data accuracy

Ribbon launches TINs, unlocking new understanding of complex relationships and improving provider data accuracy 

There are millions of healthcare providers across the United States. Many are associated with multiple organizations, and practice out of multiple locations - a provider might practice at several locations in Minneapolis, but bill from an address in St. Paul. That same provider might contract with another organization or two, with multiple service locations and billing addresses. It’s a tangled web that’s tricky to parse out, especially for large enterprises that work with thousands of providers. With so many complex relationships across the healthcare landscape, organizations must be able to map these affiliations to drive decision-making. 

‍Ribbon is launching TINs (Tax Identification Numbers) data as part of the broader Ribbon Directory offering, enabling organizations to easily map relationships between providers, service locations, and billing entities. Understanding these relationships is a key input to many workstreams across healthcare organizations, including network analysis, billing, claims processing, tax reporting, provider enrollment, and more.

The Data Details 

If you’re a Ribbon customer, you know that Ribbon Organizations has been part of the Ribbon solution for many years, primarily supporting find-care use cases. This data was primarily limited to high-level information on health systems, including the locations associated with these health systems. 

‍Ribbon is evolving our core Ribbon Directory by launching a TINs dataset that maps the relationships between providers (NPIs), locations, and TINs, including: 

• 1.3M+ unique TINs associated with the billing entities used by health systems, hospitals, clinics, and provider groups
• 618K+ locations associated with these net new TINs
• 2.4M+ providers associated with these net new TINs
• 16M+ provider locations associated with these net new TINs 
• Additional fields: 
  • TIN Entity Name
  • TIN Confirmation Flag 

Adding TINs data to Ribbon’s already robust data asset enables clear affiliations mapping between entities, and allows organizations to map linkages like: 

• NPIs <> Locations <> TINs: When Dr. Smith submits a claim for a service at 123 Main St., what is the billing entity and associated TIN associated with that claim? 
• Locations <> TINs: What are the locations associated with the TIN 12-1234567 and billing entity “Main St. Health Associates”? 
• NPIs <> TINs: What are the TINs associated with the provider Dr. Smith (NPI: 123456891)?

‍The Impact For Your Organization 

Organizations from health plans to care navigation companies and employee benefit platforms use TINs data to drive operational decisions, improve internal processes, and improve data accuracy. “Many of our customers, especially the enterprise health plans we work with, have expressed a need for TINs data to power their network analysis and optimization, and simplify billing and claims processing,” Ribbon Product Manager Preethi Siva shared. “Since health plans tend to contract with providers on a TIN level, this data is critically important as part of the provider data management process.” 

With the ability to understand complex relationships across providers, locations, and billing entities, Ribbon partners are able to dramatically increase the quality of their provider data. 

Many health plans use TINs data to analyze and optimize their networks. In combination with Ribbon's robust network data, TINs help power network analytics by reflecting the contracted groups or billing entities used by healthcare organizations. By viewing networks from the perspective of provider groups (not individual NPIs), network teams can build a more complete picture of how their networks compare with competitors and where there may be competitive gaps or network adequacy risks. TINs data is also a key input for health plans when managing billing and claims processing. Accurate TINs ensure that claims are paid to the right entity, improving claims processing efficiency and avoiding delays or complications. This data can help health plan teams expand provider coverage by revealing providers that may be missing from datasets - for example, if a health plan only has 8 out of 10 providers associated with a TIN in their directory, NPI<>TIN linkages can reveal the 2 “missing providers” that could be added to directory data.

Many digital health companies utilize TINs data to improve provider targeting for sales and marketing. By grouping providers by TINs, these organizations can target providers based on their affiliated groups, streamlining the efficiency and precision of outreach.

Others Have TINs Data - What Makes This Different? 

Ribbon is certainly not the only organization to offer TINs and Affiliations data. What makes ours unique? To start, this data will be available as part of every Ribbon solution. Whether you’re using Ribbon Foundation to access our leading data asset on 99% of all providers in the country, or leveraging the full Ribbon Provider Data Platform to manage, maintain, and improve all your provider data sources in one place, TINs data will be automatically included. 

Ribbon is the only provider data platform to include a field called “TIN Confirmed.” This field cross-references if the TIN is included in Ribbon’s IRS dataset and has claims associated with it in the last 6 months. Based on that, the field response is either “Confirmed” or “Not Confirmed” and “Not Confirmed” TINs can be flagged for review. This means that organizations can not only identify what the linkages are between providers, locations, and billing entities, but also understand which linkages are valid, and which need further validation. Ribbon CTO Nate Fox explains, “It’s great to have TINs data, but it’s even more powerful to be able to identify the data that’s confirmed as accurate. Our understanding of TIN relationships combined with Accuracy Scoring, powered by AI, is an important part of the broader Ribbon platform. Our customers can understand not only if a provider is practicing at a given location, but also what valid TINs are being transacted on at that location for that provider.”

The breadth and depth of coverage for Ribbon TINs data is unmatched. Ribbon is the only solution that compiles data from several trusted industry sources like the IRS, CMS, IQVIA, PECOS, and AHA, in addition to claims data. Many other solutions have directories and data that are solely claims-based. With Ribbon TINs data, you can capitalize on a more granular view of affiliations. Our data reveals affiliations at the billing entity level, not just at the broader organizational level. This level of granularity helps to pinpoint true financial and contracting relationships, vs. just high-level organizational affiliations.

The Future of TINs at Ribbon

New TINs data will be available within Ribbon Foundation, Ribbon Data Toolkit, and Ribbon Provider Data Platform in July, and new and existing customers will be able to leverage this data instantly. Our beta testers, specifically health plan customers, have already been using TINs to uncover new improvements in provider data accuracy. 

"This marks a major milestone in the evolution of Ribbon Directory, adding a third pillar alongside locations and providers. By being able to understand complex relationships across providers, locations, and billing entities, we are able to unlock new ways for our partners to dramatically increase the quality of their provider data,” Fox shared.   

“For example, health plans can now not only eliminate incorrect provider locations by leveraging Ribbon Accuracy Scoring, they can replace those incorrect provider locations with high-confidence provider locations using TINs data. With TINs data in the Ribbon Directory, we can easily find an alternate high-confidence location for that provider through a known in-network affiliated location. Health plans can eliminate bad data and replace it with an accurate alternative, enabling them to maintain network adequacy constraints.” 

To learn more about how TINs data can improve provider data accuracy and drive operational efficiencies for your organization, reach out to our team below. 

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