Health insurance organizations can trust NextGate to deliver high quality data that can be used to manage member care and run business operations more efficiently. As the market leader in identity management, NextGate implements proven processes to aggregate, de-duplicate, and reconcile patient, provider and organization data, no matter the source. This sophisticated approach to data management brings clarity to data exchange and integrity while providing a solid foundation for interoperability for ACO and HIE participation.
Partnerships and business models have evolved in ways that require the immediate exchange of member and provider data from multiple internal systems and external sources. Population health management via ACO, insurance exchange participation and risk agreements force precision in data accuracy, review and reconciliation.
Reconciled member and provider data can be managed to:
- Reduce claims processing errors and re-work
- Ensure error-free billing and quick medical records review
- Perform data analytics, predictive modeling and proactive outreach
- Maintain an accurate provider database
- Produce complete and up-to-date provider directories
- Feed into member and provider portals, and back to clinical locations
Use Case – The Mississippi Division of Medicaid tackles patient identity management head on to become the first Medicaid Agency in the Nation to exchange clinical data
Having access to accurate, clean and longitudinal patient and provider data streamlines processes, bringing clarity to complex data management for payers, members and providers. Contact us today to learn more about a customized data management approach for your insurance organization.