Solutions For Health Plans

Interoperability provides a clear path forward

The move to value-based healthcare is having a profound impact on health insurance. More than ever, Payers are reliant upon access to high-quality information to design and measure their business, to identify risks, and to implement financial and quality controls.

Data, healthcare, interoperability, provider, health, plan, solutions, patient, providers, members, compliance, initiatives, data management, provider directory, patient master, member, master, data migration, data governance, data quality

The freedom to adapt and innovate with Gaine

If inflexible systems and paralyzing IT costs are barriers to your companies ability to achieve a strategic advantage, then we invite you to speak with us.

Gaine provides a transformative set of tools that create and manage the information that enables payers to maximize their reimbursements from state and federal agencies, and to work with providers to reduce the overall cost of quality care. Give your data a higher purpose and transform your business for the better.

 

Fastest Time to Value

Gaine solutions are designed to be deployed quickly with minimal disruption to existing systems and processes. Within just a few weeks, Gaine solutions are up and running to start saving time and reducing cost of operations.

 

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Reduce Administrative Costs

The cost associated with poor-quality data can be crippling. Gaine has the expertise and experience managing critical Provider and Member data for Payers and Provider Groups to eliminate waste and improve outcomes.

 

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Eliminate Risk Throughout

Our experience and expertise in the healthcare space give us the insight necessary to identify project risks, and the skills to remove these from your roadmap. Tell us about your project! We are sure we can help. Contact us 

 

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No matter your organization’s size, budget, or complexity of need – we can help.

Protect revenue and reduce administrative costs to maximize profitability while maintaining the highest standards of care.

Data, healthcare, interoperability, provider, health, plan, solutions, patient, providers, members, compliance, initiatives, data management, provider directory, patient master, member, master, data migration, data governance, data quality
SOLUTIONS FOR PAYERS

Member Master

Gaine’s Member Master solution offers a flexible data platform to integrate patient information, including claims history, doctor and pharmacy visits, as well as personal demographic information. The Gaine Member Master solution combines every aspect of patient data to support proactive, value-based care that ultimately lowers costs and provides a better patient experience.

SOLUTIONS FOR PAYERS

Provider Data Management

Payers are under significant pressure to improve provider data accuracy, and to maintain these higher levels of data quality. In order to achieve the necessary levels of provider data quality, payers must be able to share information between internal systems and their contracted providers. Gaine makes this integration possible without the traditional cost and complexity.

Data, healthcare, interoperability, provider, health, plan, solutions, patient, providers, members, compliance, initiatives, data management, provider directory, patient master, member, master, data migration, data governance, data quality
Data, healthcare, interoperability, provider, health, plan, solutions, patient, providers, members, compliance, initiatives, data management, provider directory, patient master, member, master, data migration, data governance, data quality
SOLUTIONS FOR PAYERS

Data Migration Toolkit

Gaine’s Coperor platform acts as your information broker when moving from old to new systems, merging systems, or integrating with new applications. It sits between your legacy systems and your new platform to ensure that changes made in any system are synchronized according to your business rules — no lost data, no duplication, and no re-keying.

Case Study

Data, healthcare, interoperability, provider, health, plan, solutions, patient, providers, members, compliance, initiatives, data management, provider directory, patient master, member, master, data migration, data governance, data quality, symphony, provider directory, california

Building California’s Centralized Platform for Provider Data Management

Gaine provides the platform on which California’s state-wide provider directory utility is built. Learn more about the nation’s leading regional initiative for provider data management.

Data, healthcare, interoperability, provider, health, plan, solutions, patient, providers, members, compliance, initiatives, data management, provider directory, patient master, member, master, data migration, data governance, data quality, symphony, provider directory, california

More reasons to explore Gaine Solutions

Profit Optimization

  • Maximize CMS star ratings (HEDIS & CAPHS).
  • Eliminate fee schedule errors.
  • Eliminate CMS filing errors.

Reduce Administration Costs

  • Improve automated claims matching.
  • Reduce 1099 reconciliation overhead.
  • Reduce credentialing costs and improve accuracy.

 

Improve Compliance

  • Protect members’ personal information and eliminate HIPAA violations.
  • Manage Member privacy consents with full auditability.
  • Maintain and publish a standardized Provider Registry.
  • More effectively track and manage Dual-eligible members.

Improve Member Satisfaction

  • Improve Member communications.
  • Provide Members with visibility and control of their personal information.

Increase IT efficiency

  • Improve the interoperability of IT systems.
  • Reduce integration costs for new systems.
  • Reduce the cost and complexity of Member/Provider portals.

Subject matter expertise

GET IN TOUCH

Discover what true interoperability can do for your business!

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Gaine Solutions

Gaine helps leading healthcare organizations, life sciences, and biotech companies leverage information as they strive for competitive advantage and operational efficiency. Our Coperor™ platform arms our 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.

FOLLOW US ON LINKEDIN  

30%

Average Reduction in Time

TIME  

40%

Average Cost Reduction

COST  

100%

Rate of Project Success

RISK  

 

Specialization Healthcare and Life Sciences

EXPERIENCE  

News and Recommended Reading

EXPLORE MORE ARTICLES  

 

Member Master

Build a rich member profile with advanced identity management, demographics, and social determinants.

  • Member Outreach
  • Extended Member Profile
  • Population Health Data Store
  • Enrollment Management

.

EXPLORE THIS SOLUTION  

Provider Master

Gaine’s Provider Data Management suite drastically improves data quality and reduces overhead for Payers and Providers alike.

  • Provider Directory
  • Attestation
  • Roster Transformation for Payers
  • Enterprise Sync
  • Reference Data Gateway
  • Data Quality Services

.EXPLORE THIS SOLUTION  

 

New! Lexis Nexis Risk Solutions Integration

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.

LEARN MORE  

Data Migration Toolkit

Gaine’s Coperor platform acts as your information broker when moving from old to new systems, merging systems, or integrating with new applications. It sits between your legacy systems and your new platform to ensure that changes made in any system are synchronized according to your business rules — no lost data, no duplication, and no re-keying.

.

EXPLORE THIS SOLUTION  

Patient Master

Build a rich member profile with advanced identity management, demographics, and social determinants.

  • Member Outreach
  • Extended Member Profile
  • Population Health Data Store
  • Enrollment Management

.

EXPLORE THIS SOLUTION  

Provider Master

Gaine’s Provider Data Management suite drastically improves data quality and reduces overhead for Payers and Providers alike.

  • Provider Directory
  • Attestation
  • Roster Transformation for Provider Groups
  • Enterprise Sync
  • Reference Data Gateway
  • Data Quality Services

.EXPLORE THIS SOLUTION  

 

New! Lexis Nexis Risk Solutions Integration

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.

LEARN MORE  

Data Migration Toolkit

Gaine’s Coperor platform acts as your information broker when moving from old to new systems, merging systems, or integrating with new applications. It sits between your legacy systems and your new platform to ensure that changes made in any system are synchronized according to your business rules — no lost data, no duplication, and no re-keying.

.

EXPLORE THIS SOLUTION  

The Journey to Interoperability Starts with Coperor Core Services.

Coperor redefines system interoperability, combining the best of master data management, operational data store, data governance, and harmonization technology into a single platform.

 

 

  • MDM Stack
  • Enterprise Sync
  • Policy Repository
  • Data Stewarding
  • Real-time Services
  • Notification Engine

 

 

  • Third-party Gateway
  • Extended Support
  • ODS Integration
  • Audit Manager
  • SFDC Toolkit
  • Implementation Services
NEW WHITEPAPER

Understanding the Provider Data Management Lifecycle

Learn how traditional provider data management methods are costing your healthcare organization in a big way and what to look for in a modern provider data management solution.

Subscribe below to receive the PMD Lifecycle Whitepaper in your inbox, instantly. 

Get the Whitepaper

Patient Master

Fast implementation, purpose-built industry applications, and scalability from start-up to Fortune 100.

  • Master Data Management
  • Data Governance
  • Enterprise Master Patient Index(EMPI)
  • Third Party Data Integration
  • Industry Model for Patient Data
  • Seamless Integration with CRM

.

EXPLORE THIS SOLUTION  

Data Migration Toolkit

Gaine’s Coperor platform acts as your information broker when moving from old to new systems, merging systems, or integrating with new applications. It sits between your legacy systems and your new platform to ensure that changes made in any system are synchronized according to your business rules — no lost data, no duplication, and no re-keying.

.

EXPLORE THIS SOLUTION