Payers are under constant pressure as the industry is shifting to value-based care. It will benefit the patient, the healthcare provider, and the payer. The timely disbursement of payouts requires having a reliable data platform that offers the payer with the provider data. Hence an Integrated Payer platform is essential.

The industry is witnessing a data-driven healthcare revolution with widespread digitization of electronic health record systems. But with compelling opportunities, we also see massive data volumes, evolving patient expectations, and expanding regulations. Data in varying formats from an increasing array of sources must be integrated to ensure optimal outcomes, whether obtaining a diagnosis, ensuring accurate claims processing, developing new pharmaceutical treatments, or addressing regulatory challenges.

The impact of data-driven healthcare upon the patient care decision process via accurate, real-time, reliable data from different sources is at the heart of the digital revolution in the healthcare sector. Physician groups, nursing facilities, pharmaceutical companies, hospitals, medical equipment, clinical researchers, and manufacturers churn out massive amounts daily. This integrated payer platform has tremendous value and can improve faster care possibilities and real-time decisions and help deliver new, unimagined innovations with better patient care quality. Data-driven healthcare is beginning to have a big impact with Payers. The primary drivers include controlling the increasing medical costs and building cost optimization and efficiencies into the integrated payer platform model based on data and business insights.

Payor Platform Data Sources

The growing payer platform data sources include:

• Provider Info
• Patient Info
• Billing
• Health plans
• Claims
• Clinical
• Eligibility

Data Interoperability—A Roadmap for Effective Payor-Provider Collaboration

An ideal integrated payer data system considers best practices to enable easier decisions that reduce cost by collaborating with providers to access and share credentials and capabilities. Our Flagship Product ConCred is designed to create a seamless data interoperability between payers and providers, thereby eliminating disparate data sources. ConCred provides compliance standings and assimilates data that provides actionable and meaningful insights.

The primary benefits of having an integrated payer data system is to:

• Detect medical fraud
• Reduce Re-admission
• Customer experience
• Provide faster care
• Full control over the capacities and capabilities

The healthcare payer systems landscape is complicated and fragmented across the industry with multiple data sources. The difficulty and cost of integrating, managing, and storing data is a constant issue for everyone within the healthcare ecosystem. The payer ecosystem has multiple disparate systems exist that have a variety of data formats that make integrating, exchanging, and harnessing data a challenge.

ConCred, offers an integrated payer platform for data to enable the payers to make their claims process faster, seamless, and thereby enhancing the customer experience. “ConCred,” an integrated connected payer enrollment and credentialing system. ConCred comes with a Configurable Data Dashboard.

Payer Dashboard

Our integrated payer platform system’s analytics modules allow the payer to aggregated data and to be able to visualize data intelligently. ConCred helps the payers improve efficiency with organizational processes through easy-to-follow reports and performance metrics.

Unlike a Traditional reporting system, which typically displays data in a columnar or tabular format, ConCred can represent data graphically and through multiple interactive reports. So, the user can create different views and discover meaningful patterns in critical provider data. Organizations can lessen patient wait-times by using healthcare payer data analytics to monitor and leverage scheduling and staffing procedures with minimal errors and enhance employee satisfaction.

The Integrated Payer Platform dashboard can be configured based on multiple views like tiled based, Widget based, graph based, and it comes with drill up and drill down functionalities. Data can be filtered out based on various segments like profile, role, or department wise.

ConCred cuts across various target segments and can be highly customized basis the needs of different client types, whether a therapy Center, a hospital, an insurance company, a solution provider, or a larger Systems Integrator. ConCred is ready to deploy software with minor customization, depending on the client type.

For more details and to schedule a demo, please feel free to write to contact@humanebits.com