Enclarity solves healthcare's provider information problem.

 

Good data. It's crucial to the efficiency and profitability of organizations submitting or processing healthcare claims. The problem is that much of the provider information you work with is outdated or full of errors. It costs you money and damages relations with your members and customers.

 

How big of a problem? Consider this: each year, more than 20 percent of providers change their addresses, five percent change their status and 30 percent change their affiliations. At any time, more than three percent of physicians have disciplinary action. As a result, on average, 30 to 40 percent of the provider records maintained by payers, PPOs and other healthcare organizations contain errors or are missing data. Over 5 percent of claims can't be processed electronically because of poor provider data quality. Up to 15 percent of all correspondence and payments to providers are returned because of address errors. And the cost of fines and penalties resulting from non-compliance is staggering.

 

In all, outdated or incorrect provider information costs healthcare payers over $26 billion every year.

 

Keeping track of ever changing provider information across the variety of provider types and locations is and ongoing process, not a one-time project. This specialized area is not a core competency of internal IT staffs or even the leading IT consultants. To be successful, you must first find, and continually monitor, thousands of information sources. You then must effectively apply sophisticated standardization, cleansing and database techniques to prepare the data. And you need all this just to be ready to use the advanced analytical methods required to accurately match records and to determine which sources contain correct, current data for each attribute. Some critical issues, such as establishing and maintaining the right associations between providers and groups, also require an up-to-date and in-depth understanding of industry-specific data sources and practices.

 

With that done, you've only reached the point where the information is ready for use in your operations. To realize value you must match and integrate the data with all the internal sources and systems that require it, and deploy it all the points of service where it is needed.

 

That's why you need to know about Enclarity. We deliver correct, current and comprehensive provider information solutions by blending thousands of data sources, advanced analytics and deep healthcare expertise. As a result, our clients improve results in many areas, including claims processing, provider directories and network analysis. And by increasing the integrity and reliability of your provider records, and keep them that way, you can greatly increase your productivity and profitability.

 

The marketplace is taking notice. In 2007, Enclarity was named one of the Top 100 private technology companies in North America by Red Herring magazine and awarded the Global Healthcare Information Technology Excellence Award by Frost & Sullivan. With our corporate headquarters in Aliso Viejo, California, and a development and client services office in Minneapolis, Minnesota, Enclarity's investment partners include Bain Capital Ventures and Ignition Partners.

 

Ready to take the next step? Click here to learn how we can help bring your organization's provider information into focus.