eProviderSync™ - Provider Data, Directory and Contract Management Solution
 

Simplify Provider Data, Directory, and Contract Management.

  • Load provider data and contracts once and integrate this information across the enterprise.
  • Maintain data accuracy and resolve conflicts with our IntelliMatch capability.

 
 
 
 

Consolidate provider data and contracts into a single source of truth. 

Provider directory management lifecycle automation

Automate end-to-end provider lifecycle.

eProviderSync™ is a patent-pending SaaS based provider and provider contract management solution.  It automates the end-to-end provider life cycle, so you can create a single source of truth for providers. 

Provider directory management solution developed by health plan professionals.

The only solution developed by health plan professionals.

House all types of providers and extend the provider models to include the innovative affiliations demanded by Value Based Purchasing and Contracting.

Provider contract management solution to Improve Net Promoter / Customer Satisfaction scores

Improve Net Promoter / Customer Satisfaction scores.

eProviderSync™’s ability to improve data accuracy ensures consistency of provider data and contracts across the health plan. This further improves the net promoter and customer satisfaction scores.

 
background-blue-eps-6.jpg
 

Why eProviderSync™ ?

eProviderSync™ improves the speed, accuracy, compliance and cost-effectiveness of provider data and contracts.

Provider Onboarding

Improve quality and timelineness up to 70%

Provider Contracting

Automate your provider contracts (new and changes) up to 90%

Provider Directory

Improve quality and accuracy up to 75%

Data Reusability

Increase data reusability up to 95%

Claims Recoveries

Decrease claims recoveries up to 70%

Maintainance

Decrease provider data and contract maintainance timeframes up to 60%
 
background-white-sh.jpg
 

An end-to-end solution for eliminating disparate legacy systems and error-prone processes.

 
Provider Contract Management and Configuration
 

CONFIGURE.

  • Simplify configuration of providers and provider contracts with intelligent decision support for provider data, directory, network and relations teams

  • Comply with configurable guardrails for regulations, business policy via centralized business rules

  • Flexibly capture ALL types of providers and contracts:

    • Commercial and Government

    • Standard and Custom

    • Value-based purchasing

    • Ancillary (Dental, Vision, Pharmacy, STD, LTD, Life etc.)

 
Effortless collaboration across Provider data management lifecycle
 

COLLABORATE.

  • Engage all stakeholders via integrated use-case specific workflows vs. emails

  • Incrementally build providers and contracts with inputs across teams

  • Annotate and track changes for regulatory and business communication content from single source

  • Robust audit trails enable compliance to regulatory agencies and external auditors

 
Efficient Provider Directory  Communications
 

COMMUNICATE.

  • Generate all communications document materials from the single source – provider notifications, credentialing, authorizations, contracts

  • Seamlessly integrate provider and contract information via ETL, Web API or Batch files to/from:

    • CRM (Salesforce, MS Dynamics, Siebel)

    • Core-Admin

    • Provider directory

    • Portals (Member, Provider, Customer Service, Broker, Agent)

    • Credentialing (Cactus)

    • Authorization / Referrals

    • MDM (Master Data Management)

    • Modeling tools (Quest Analytics, Homegrown)

 
 

Frequently Asked Questions (FAQ's)

Please click on question to explore more

A. The management of Provider networks by Health Plans follows a series of steps starting from Provider contracting and onboarding to credentialing, claims management, value-based payments, and much more. The process of managing end-to-end Provider lifecycle is known as Provider Lifecycle Management.

A. Our solution, eProviderSync™, automated the Provider lifecycle by ingesting your provider data from your internal and external sources to create the single Source of Truth for all provider information. From here, you can configure your data to comply with guardrails for regulations and business policies via centralized business rules. With eProviderSync™, you can collaborate with all stakeholders to manage your provider data with robust workflow capability, including routing, notifications, and a logging function to track all changes.

A. Challenges with traditional Provider data management processes:

  • Rigid systems that force you into their workflow, not your own
  • Multiple provider data repositories
  • Inaccurate provider directories are creating member dissatisfaction
  • Inconsistent and erroneous provider data across health plan departments and systems
  • Provider data difficulties can hurt a health plans’ CMS Star Ratings

A. The Golden Data Record is the data sitting in the Single Source of Truth that is most current and accurate. This Golden Data Record may be the result of algorithms that fuse multiple internal and external data sources. SmartEnroll™ enables you to support individual or mass enrollments, benefiting from a pre-population of data from your external reference data sources to minimize data entry and the risk of typing errors. IntelliMatch™ enables you to continue to match new data that comes into your system via internal and external sources to the correct provider record, so that the Golden Data Record reflects the single, disambiguated, and most current data representation of a provider.

A. By automating the Provider lifecycle process, Health Plans can:

  • Load provider data and contracts once and integrate this information across the enterprise.
  • Eliminate the data conflicts between multiple repositories.
  • Manage operations with how you chose to run your business, not how inflexible software may be designed.
  • Maintain data accuracy and resolve conflicts with our IntelliMatch™ capability
  • Improve the speed, efficiency, compliance, and cost-effectiveness of provider data and contracts.
  • Keep provider directories current improving member experience.
  • Improve CMS Star Ratings

 
background-white-sh.jpg
 

What our customers say.

DIRECTOR, PROVIDER CONFIGURATION

We are excited to see a solution like eProviderSync™ in the market. It will help us streamline our legacy manual processes and improve accuracy and speed to market significantly.

quotes_icon

FORMER LARGE HEALTH PLAN PROVIDER EXECUTIVE

In my opinion, eProviderSync™ is the only end to end solution that can help solve the Provider data and contracting challenge in the industry at the root cause. It creates a robust, configurable single source of truth and has a intelligent algorithm to the keep the data updated.


background-blue-eps-2.jpg

Ready to get started with eProviderSync™?

Ready to get started.png