Payers can leverage top quality provider data seamlessly integrated into their internal workflows and business systems

LexisNexis® Risk Solutions is collaborating with Gaine Healthcare to offer health plans a powerful and effortless way of maintaining more accurate and continually updated provider data, addressing the needs of various stakeholders within the payer organization.

The collaboration will allow payers to quickly assimilate robust provider data from LexisNexis® ProviderPoint and LexisNexis VHCP® and execute business and systems integration and resultant downstream actions through Gaine Healthcare’s Coperor Data Integration Platform.  LexisNexis® ProviderPoint® is a proven, powerful, hosted solution that assists health plans with a systematic way to keep their provider information accurate and up-to-date while significantly reducing operating costs. Used by more than 70 health plans, including 8 of the top 10 in the U.S., ProviderPoint leverages over 3,000 authority sources, over 1.6 billion medical claims annually and a robust payer contributory database to offer a current and comprehensive provider database in the US. LexisNexis VHCP® is a hosted, crowd-sourced, real-time data management and analysis solution that optimizes data insights for payers designed to meet federal and state regulations for provider data accuracy.

Gaine Healthcare’s Coperor Data Integration Platform currently enables the nation’s largest healthcare payers to access new information quickly and manage multiple source systems records while reducing integration costs. Coperor is capable of ingesting data streams and executing business and systems integration resulting in downstream decisioning and action.

With the combined solutions, payers will receive the following benefits

  • Leverage LexisNexis Risk Solutions’ provider data without the need to change existing operation or analytic systems. The service includes data cleansing, enrichment with validation, correction and augmentation, and regular monitoring for changes.
  • Maintain multiple views of providers to support differing needs across health plan operations.
  • Provide data services to simplify the exchange of information between systems.
  • Orchestrate the distribution of data updates to internal systems, business process owners and external trading partners.
  • Establish a central point of control for data governance as well as integration.

Inconsistencies and inaccuracies in provider data assets remain a costly and complicated problem for health plans. It’s vital that payers address the challenge systemically so provider data can be updated, integrated, and managed with ease. Through this collaboration, payers can close information gaps and seamlessly assimilate the data into their workflows.

About Gaine Healthcare
Gaine helps leading healthcare organizations, life sciences, and biotech companies leverage information as they strive for competitive advantage and operational efficiency. Gaine’s Coperor™ platform arms its clients with Information Agility™ which maximizes flexibility, minimizes cost and time-to-value, and eliminates the risks associated with implementing new systems, migrating existing systems, and integrating data from internal and external sources. For more information, please visit gainehealthcare.com.

Source:  LexisNexis Risk Solutions Press Release