Cloud-based provider and network data management solution for managing complex provider relationships, networks, facilities and contracts with a flexible and scalable approach.
Healthcare organizations are faced with an everchanging and demanding regulatory environment that requires constant compliance updates and consistent processing. In addition, there are a growing number of complex associations between providers, doctors, groups, hospitals and insured members. Managing the accuracy and consistency of provider information, along with the provider information as it relates to each association or relationship, has become very challenging.
- Provides scalability and flexibility to create unlimited relationships between networks, providers, service locations and line of business
- Enhances productivity through access to a real-time single database of providers information and complex associations
- Utilizes a unique four-tier system to create and manage complex and multiple relationships and multiple Lines of Business
- Allows viewing of information that is relevant for a particular provider type, e.g. facility vs. physician through its provider-type centric user interface
- Prevents duplicate Provider data entry based on a unique duplication review process that includes NPI, Tax ID and other provider data points
- Has a built-in API call out and database reference from NPPES with the ability to verify provider status and update missing provider data points
- Ability to do user defined mass external Provider data uploads with:
- User visibility of data during the process
- User data corrections or rejections during the process
- User defined business rules applied to the workflows that manage the process
- Ability to interface with core healthcare systems, serving as a record of truth for more accurate claims processing, provider directories and any provider data extracts needed