eProviderSync™ - Healthcare Provider Data, Directory and Contract Management Solution

Simplify Provider Data and Directory Management

Consolidate Provider data and directory into a single source of truth with end-to-end automated Provider lifecycle administration that helps health plans improve claims processing quality and reuse Provider contract language using automated business rules and intelligent algorithms to keep the data updated.

  • Automate the creation of a “golden record” internal Provider data source with IntelliMatch™ to external primary sources.
  • Digitize the Provider onboarding and enrollment experience and seamless contract generation with SmartEnroll™ capabilities.
  • Reduce the risk of penalties and member complaints, improve Provider satisfaction, and CMS star ratings hassle-free.

eProviderSync™, a leading-edge Provider data, directory, and contract management solution, helps consolidate Provider data and contracts into a single source-of-truth.

Leveraging health plans with the emerging business rule-driven solution to automate the end-to-end Provider lifecycle administration and improve quality and timeliness by up to 70%.

Simplify complex processes with an automated solution

eProviderSync™ is a SaaS-based Provider contract management solution that automates the end-to-end Provider lifecycle so that you can create a single source of truth for Provider data with a push of a button.

An intelligent solution developed by health plan professionals

Built by health plan professionals, eProviderSync™ can help solve the Provider data and contracting challenges at the root cause. It has unique SmartEnroll™, IntelliMatch™, and contract generation capabilities to automate Provider contracts by up to 90%.

Improve net promoter/customer satisfaction scores

eProviderSync™’s ability to improve data accuracy ensures consistency of Provider data and contracts across the health plan. This further enhances the net promoter and customer satisfaction scores as well as improves CMS Star ratings.

Digitize the enrollment experience with SmartEnroll™

Accelerate the Provider onboarding, enrollment, and contract generation process via SmartEnroll™. Further, improve quality and accuracy by up to 75% and reduce claim recoveries by up to 70%.

<p>&nbsp;</p>

Why eProviderSync™?

Whether it is streamlining Provider lifecycle management or contract generation process or enabling new operating models, we’re helping health plans transform and improve Provider satisfaction with just a few clicks.
%
Provider Onboarding

Improve quality and timelineness up to 70%

%
Provider Contracting

Automate your Provider contracts (new and changes) up to 90%

%
Provider Directory

Improve quality and accuracy up to 75%

%
Data Reusability

Increase data reusability up to 95%

%
Claims Recoveries

Decrease claims recoveries up to 70%

%
Maintainance

Decrease Provider data and contract maintainance timeframes up to 60%

Discover how eProviderSync™ can help health plans automate Provider data, directories, and contract management using a single source of truth.

Application Modules

Our Provider data, directory, and contract management solution can be molded to reflect your business! Scale to new frontiers with our cutting-edge modular integrated solution.
Create single source of truth for your plan data

Take control of your data by managing its configuration and use

Establish a single source of truth to consolidate Provider data and directory into a single source of truth, annotate and track changes for regulatory and business communication content, eliminate Excel grids, automate workflows and routing of information between various teams using .Source
Auto-generate documents to meet regulations

Automate document generation and version management processes

Automate the creation of a “golden record” internal Provider data source with IntelliMatch™ to external primary sources, and auto-generate documents and contracts with SmartEnroll™ capabilities. Enable omni-channel re-use of the language and dynamically generate print-ready documents to meet regulations or share your information on web portals or through print with .Docs
Improve claims management accuracy

Simplify configuration of benefit plans and keep your claims system up-to-date

Configure your data and directory one place with intelligent decision support, eliminate repetitive data entry into Core-Admin and other systems, keep your claims system up-to-date, and automate the maintenance of your product configuration with .Claims
Seamlessly share information across the enterprise

Automate the integration of key benefits data and documents into essential systems

Improve data accuracy and ensure consistency of Provider data and contracts using single source of truth. Seamlessly integrate data across the enterprise with and from your technology ecosystem via RESTful APIs, Event-based APIs, Data streaming via KAFKA or Event Hub, ETL, batch files using .Integrate
Access user configurable data in few clicks

Expose your user-configurable data to standard reporting tools

Ensure your dynamic pristine data is integrated with your Master Data Management investments and is available in real-time to your reporting and business intelligence tools using the relational database format and flexibly capture Provider onboarding, enrollment, and directory management information using .MDM

Frequently Asked Questions (FAQ's)

Here are the most common, frequently asked questions about implementing end-to-end Provider lifecycle management solution and partnering with Simplify Healthcare.

1. What is Provider lifecycle management?

The management of Provider networks by health plans follows a series of steps starting from Provider contracting and onboarding to credentialing, claims management, value-based payment reconciliation. The process of managing the end-to-end Provider lifecycle is known as Provider lifecycle management. For payers who have made investments in Provider data repositories and need to preserve those investments, the Provider lifecycle management solution can flexibly work with existing repositories as a wrapper, enabling its functionality without replacing the current investment. Critically, this union can behave as a single source of truth.

2. How can you automate the Provider lifecycle?

eProviderSync™ is an integrated enterprise solution to automate the end-to-end Provider lifecycle, create a single source of truth, and maintain data accuracy.  It helps configure Provider data to comply with guardrails for regulations and business policies via centralized business rules. With eProviderSync™, you can collaborate with all the stakeholders to manage Provider data, achieve administrative savings, reduce Provider service calls, improve call handle time, and reduce claim rework with robust workflow capability, routing, notifications, and a logging function to track all changes.

3. Why use a Provider lifecycle management solution?

Provider lifecycle management is considered one of the core processes needed for health plans, yet they are struggling to generate accurate data, directories, and contracts. The root cause is that health plans often rely on legacy systems and continue to create conflicting data repositories, lacking a single source of truth. Traditional Provider data management processes are time-consuming and impose challenges such as –

  • Tedious, manual, error-prone, and time-consuming Provider onboarding and contracting process.
  • Inaccurate Provider data and inconsistency across all touchpoints create member dissatisfaction.
  • Poor Provider data quality impacts CMS Star ratings.
  • Multiple provider data repositories.
  • Single application view to view/edit Provider information is time-consuming.

eProviderSync™ is the only end-to-end solution that can help solve the Provider data and contracting challenge in the industry at the root cause.

4. What is the golden data record, SmartEnroll™, IntelliMatch™ capabilities?

The Golden Data Record is the most current and accurate data sitting in a single source of truth. This golden data record may be the result of algorithms that fuse multiple internal and external data sources. Automate creating a “golden record” internal Provider data source with IntelliMatch™ to external primary sources. IntelliMatch™ enables health plans to continue to match new data that comes into the system via internal and external sources and correct the Provider record with just a few clicks so that the golden data record reflects single, disambiguated, and current data.

SmartEnroll™ enables health plans to digitize the enrollment experience, support individual or mass enrollments, benefit from a pre-population of data from external reference data sources, minimize data entry, and risk typing errors.

5. What can you improve in your Provider lifecycle by automating the process with eProviderSync™?

By automating the Provider lifecycle process, health plans can:

  • Load Provider data and contracts once and integrate this information across the enterprise.
  • Resolve data conflicts between multiple repositories, maintain data accuracy, and increase data reusability by up to 95%.
  • Achieve administrative savings by reducing Provider service calls, improving call handle time, and reducing claim rework.
  • Automate creating a “golden record” internal Provider data source with IntelliMatch™ to external primary sources.
  • Digitize the enrollment experience with SmartEnroll™.
  • Accelerate Provider onboarding, enrollment, and seamless contract generation.
  • Improve the speed, efficiency, compliance, and cost-effectiveness of Provider data and contracts.
  • Improve Provider data and directory for reduced risk of CMS penalties and member complaints.
  • Improve Provider satisfaction and CMS Star ratings.

What our customers say.

''We are excited to see a solution like eProviderSync™ in the market. It will help us streamline our legacy manual processes and improve accuracy and speed-to-market significantly.''
Director, Provider Configuration
''In my opinion, eProviderSync™ is the only end-to-end solution that can help solve the Provider data and contracting challenge in the industry at the root cause. It creates a robust, configurable single source of truth and has an intelligent algorithm to keep the data updated.''
Former Large Health Plan Provider Executive

Ready to get started with eProviderSync™?

Are you interested in learning more about eProviderSync™? Our team is ready to answer all your questions. Let’s make smarter health ecosystems together! Schedule a 1:1 demo with us today!
Schedule a Demo

Explore our Contract Lifecycle Management Solution

Provider, Employer Group, and Member Contracts Management