Sessions

Master Data Management System Solves Provider Matching Issues

Differences in operating platforms present challenges for health plans. AmeriHealth Caritas Family of Companies, a network of over 500,000 physicians serving more than 2M lives, faced duplication and proliferation of conflicting provider data. Data quality issues affected the accuracy of directories, reimbursement for services, and credential verification. AmeriHealth implemented a master data management system, resolving the data-quality issues in less than three months.

Results

  • One key index per provider, linking records across numerous platforms for 500,000 providers.
  • Geocoded, USPS provider addresses, enabling spatial analysis and improved data management.
  • Standard titles, credentials, degrees, specialties, all linked to nationally recognized standard terminology.

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