Provider Network Data Management

Our provider network data management process mitigates increased labor costs due to the enhanced complexity of provider payment arrangements and provider network contracts. Efficient provider credentialing services avoid incorrect contract rates in claims.

Case Studies
Claims Management - Process Innovation and Technology Result in Cost Reductions
The Challenge: Prohibitive labor cost and considerably higher turnaround time due to large number of manual adjudications resulting from mismatched information between enrollment data and provider data.
Provider Data Management - Process Innovation and Technology Result in Cost Savings
The Challenge: A cost intensive update process required checking data on all provider information update forms, rather than the ones which were actually changed (typically only 40%).