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A MDM Success Story: Streamlining Claims Processing and Payments With Reliable, Centralized Data

Multi State Integrated Health Network

Does this sound familiar: you’re running multiple point-of-care systems, each with redundant data points collected. But what happens when there are small variations in how data is captured and processed across these systems? As a healthcare provider client of ours discovered, inconsistent data can reduce revenue realization. It caused claims to be improperly matched and processed… then denied – a stressful, frustrating, and business-impacting experience.

We partnered with the provider to consolidate their siloed data. Our Agile practitioners recognized the organization’s challenge as a prime use case for Informatica, an automated solution that would compare, streamline, and harmonize patient data in order to establish a single, reliable source of truth and boost claims processing efficiencies.

READ MORE: We’re A Cloud and On-Premises Certified Informatica Partner  Master Data Management: Modern Use Cases for Healthcare

Increasing Revenue and Improving Cycle Processing With a Single Source of Truth

To deliver a single source of truth, our team of industry and technical experts partnered with the provider to achieve the following:

  • Created a shared vision and enabled teams for the new solution’s rollout.
  • Built an automated solution on Informatica’s Data Quality and Master Data Management Hub to ingest, cleanse, compare, and consolidate data between various internal and external sources, proactively identifying mismatches for quick resolution.
  • Established a Center for Enablement (C4E) to oversee information governance and resolve process gaps across multiple workstreams.

Data quality improvements achieved with this solution significantly reduced the cost and complexity associated with integrating newly acquired hospitals, increased the frequency of successfully billed patient claims, and limited confusion and frustration associated with providers’ attempts to understand and reverse denied claims.

And the results are impressive. Want to learn more? Check out the complete success story here.

DISCOVER EVEN MORE SOLUTIONS: Master Data Management: Modern Use Cases for Healthcare

Healthcare MDM Solutions

With Perficient’s expertise in life scienceshealthcare, Informatica, and Agile leadership, we equipped this multi-state integrated health network with a modern, sustainable solution that vastly accelerated the revenue realization cycle.

Have questions? We help the healthcare organizations navigate healthcare data, business processes and technology, and solution integration and implementation. Contact us today, and let’s discuss your specific needs and goals.

Thoughts on “A MDM Success Story: Streamlining Claims Processing and Payments With Reliable, Centralized Data”

  1. This is some great information; I love the part about the Single Source of Truth. It is a concept that can be applied in many areas of life and business. Wonderful, simply wonderful. Thank you for the authoritative insights and solid data.

  2. I think you made the right decision, because thanks to artificial intelligence, computers can take over the collection of information and the detailed study of unstructured data,
    which as a result increases the efficiency of processing claims and payments and the procurement process.

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Cassidy Rimmey

Cassidy Rimmey is a Marketing Coordinator in the healthcare industry at Perficient.

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