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.
The freedom to adapt and innovate with Gaine
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.
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.
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
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.
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
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Discover what true interoperability can do for your business!
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