Gaine’s Provider Data Management suite drastically improves data quality and reduces overhead for Payers and Providers alike.
Payers have multiple systems that rely upon accurate provider information. These systems tend to exist independently of each other, and as a result, may contain conflicting, ambiguous, or outdated provider data. Avoidable manual processes, rework, and processing errors resulting from this poor-quality provider data impose a significant administrative cost and operational risk to any health plan.
Some of the nation’s largest health plans and hundreds of provider groups have found a better way – with Gaine’s Provider Data Management suite.
Key Features of the Gaine Provider Data Management Suite
Our Provider Directory solution is a collaborative platform that enables provider organizations and health plans to exchange provider information in an efficient process that reduces administrative overhead for both parties.
It eliminates unnecessary outreach by phone and fax to medical offices and gives providers a trusted platform to collect and distribute information to health plans.
The Gaine platform is the backbone of the California state-wide provider directory utility – the most sophisticated and large scale initiative of its kind anywhere in the world.
Providers using the Gaine Attestation process have seen a dramatic reduction in the time and resources required by this process.
Roster Transformation for Payers
Gaine’s Roster Transformation solution will translate all roster data into health plan standards, apply specific business validations, and report on conflicts in an online management dashboard.
Each organization can leverage Coperor Private Instance to selectively distribute provider data updates to any system based on business rules and system-specific transformations.
Reference Data Gateway
Maximize value from externally curated provider data by ensuring that data is applied according to your organization’s data policies without the risk of overwriting your own valuable data.
Our solution uses business rules to determine which updates will be distributed to each system. Updates can be routed to data stewards for validation before being transmitted to operational applications for additional safeguards.
Data Quality Services
We empower each organization to develop data policies for all provider related data. These policies are applied to all systems connected to Coperor Private Instance, resulting in workflows, automated fixes, or notifications to impacted parties.
Data quality metrics are reported to a data quality dashboard, and a machine learning process refines data integration rules based on choices made through the workflows.
Building California’s Centralized Platform for Provider Data Management
Gaine provides the platform on which the California state-wide provider directory utility is built. Learn more about the nation’s leading regional initiative for provider data management.
Help ensure regulatory compliance
Reduced administrative headaches
Our Attestation solution eliminates roster processing and simplifies regulatory attestations by comparing your data to the health plan data and automatically generating the reports required by each plan.
Improved provider experience and relationships
Its time to get off the hamster wheel, automate provider data maintenance, and enable your provider relations group to invest its time in developing provider relationships.
Single point of control
Payers can control the distribution of provider data to connected applications using an extensive set of business transactions that manage the lifecycle of provider data. The unique Coperor Opt-in Synchronization ™ process allows each application to preserve its autonomy without sacrificing control or visibility across the enterprise.
Collaborate with partners
Reduced administrative costs
Our Provider Data Management tools will reduce this unnecessary overhead arising from bad provider data.
Ensure data privacy protection
With the Gaine platform, payers are no longer reliant upon data collection agencies for provider data validation.
Why Payers Choose Gaine for Managing Provider Data
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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