Operational Transformation Provider Management Solutions

We help you improve your Provider Management capabilities through your Core Administrative Processing System (CAPS) and through other third-party solutions.

Provider Management is a challenge for virtually every health insurance company.  Provider data can become outdated for a variety of reasons.  Providers move or change affiliations, contracts are renegotiated involving new payment terms and data entry errors are made.   Incorrect provider data can increase the costs of claims processing, delay payment of claims and disrupt enrollment.

Our Provider Management Solutions include:

  • Provider Management Assessment
  • Provider Data Analysis
  • Provider Data Clean Up
  • Provider Management Analysis and Process Improvement
  • Provider Management Training

Improved Provider Management typically results in more accurate claims processing, more accurate and timely payments to providers and increased provider satisfaction.

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