MDI Network

Data Accuracy & Analytics

Overview

In today’s demanding data-driven world, having an inaccurate, incorrect or out-of-date provider or member data is simply not an option. Bad data leads to bad outcomes. Something as simple as improperly maintained provider data files could have devastating effects all across the enterprise. Irregularly or poorly implemented maintenance processes can lead to compliance issues, risking massive fines and loss of revenue. Similarly, inaccurate member data leads to wasted administrative time and expense, member frustration and associated attrition, and financial penalties.

MDI NetworX can help you keep the provider and member data accurate. In addition, we can run advanced analytics on your data to deliver enhanced member experience and better outcome of your business processes. Our specific focus areas on provider and member management fronts are as follows:

MDI Advantage

MDI Network

Improve Accuracy
and Turnaround Time

MDI Network

Increase Electronic
Processing

MDI Network

Drive Operational
Productivity

MDI Network

Reduce Transactional
Cost

MDI Network

Enhance
Member Satisfaction

Capabilities

Healthcare Payers are facing a growing pressure to control costs and increase profitability. In order to help meet these goals, we have been strengthening our capabilities to manage vast volumes of claims, provider, and other demographic information.

We have a two-pronged approach:

  • Ensure accuracy of provider and member information at all times
  • Leverage information to get actionable insights for our clients

We have been investing in our capabilities and have both the advanced technology infrastructure along with the required analytical talent to work on your data-driven projects.

01 Provider Data Accuracy

We ensure accuracy of Provider data by performing following tasks:

  • Add and maintain critical provider information into claims adjudication system.
  • Setup provider groups and facilities in addition to individual providers accurately.
  • Manage provider attributes such as indicative sections, multiple locations, addresses, payment information, tax information, out-of-network and additional details.
  • Update missing or incorrect provider information in order to release pended claims.
  • Removal of obsolete providers to ensure correctness of information at all times.

02 Member Data Accuracy

We ensure accuracy of Member data by performing following tasks:

  • Validate integrity of new enrollee information.
  • Update demographic data in a timely fashion to maintain accuracy
  • Capture qualitative and quantitative member interaction data.
  • Coordinate with employer groups for flow of information
  • Collection and preparation of member data to meet compliance regulations

03 Analytical Services

We support special projects of our clients in following areas:

  • Competitive intelligence and comparative product analysis.
  • Population health assessment
  • Standardized and on-demand reporting
  • Business intelligence/ dashboards
  • Bespoke analytical services

Let's get started.

We know profitable growth is important to you. Give us an opportunity to partner with you.