Industry Solutions

Healthcare Industries

Golden Provider Data for increased auto-adjudication of claims, compliance and higher customer satisfaction

The Challenge

There are a number of trends creating challenges in Healthcare and putting pressure on basic business processes and administrative functions. Increase consumerism, larger volume and variety of plans have added complexity, online market places, customer choice added competition.

The Problem the industry running into is notoriously bad data quality….specifically Provider data, which impacts several process weather managing provider networks associated with plans or paying claims

All this bad data is causing significant impacts…from high cost to maintain and update all this information….penalties associated with failing to meet requirements…and low customer Satisfaction, numerous complaints…. study in CA showed 50% of consumer complaints were about inaccurate provider information, several lawsuits underway, services performed thought in network, billed as out of network. A lot of cost and risk stemming from bad provider data, some estimate put the cost at $30M a year, large health Payer.

Trends
Functions
Trends

Increased Consumerism

Regulatory compliance requirements

Digital transformation resulting in vast new repositories of data

BADDATA

bad-data

Incomplete

bad-data

Not Current

bad-data

Duplicated data

Functions
settings

Administration

settings

Legal

settings

Analytics

NEGATIVE IMPACT

Higher Administrative cost

Non-Compliance, penalties

Lower customer satisfaction, litigation

DvSum Solution

This the problem we solve, and our solution combines, both a trusted data source, on the left. Call Golden Provider Source, which we offer through a data quality service. Looking specifically at the Provider Data Source, see data quality levels – (service levels) we deliver overall accuracy, provider profile accuracy.  So feeding into our process, several standard sources, National Plan & Provider system, Medicare/Medicaid Services, and others….

Also DvSum specific approaches from healthcare personal groups, technology-driven approaches….

Bring that all into our platform, work our magic, turn out the Golden Data Source

DvSum-solution
authoritative-source-for-provider-information
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Get free consultation with DvSum

We'd love to show you our platform, technology and discuss with you, how we can help you get more value out of your data.