Healthcare organizations, insurers, and networks suffer from inaccurate, fragmented, and outdated provider data — leading to claim denials, compliance risks, patient dissatisfaction, and significant administrative costs. Manual processes and siloed systems exacerbate the issue, making real-time updates and data accuracy nearly impossible to achieve at scale.
Provider Data Management (PDM) is an enterprise-grade platform that centralizes, cleanses, validates, and governs provider data across payer and provider ecosystems. It eliminates the inefficiencies of traditional workflows and ensures ongoing regulatory compliance (e.g., CMS, NCQA, No Surprises Act). Designed for scalability and interoperability, PDM keeps your provider directory accurate, current, and audit-ready.
Our AI-powered Confidence Scoring Engine assigns a trust score to every provider data field—empowering systems to prioritize only the most reliable information.
In a healthcare landscape shaped by increasing regulation, digital transformation, and rising patient expectations, accurate provider data is no longer optional—it’s essential. From improving claim integrity and ensuring compliance to enabling precise referrals and seamless patient experiences, fragmented provider data costs organizations millions. PDM is purpose-built to solve this challenge—delivering a unified, intelligent, and compliant platform that transforms provider data into a strategic asset.
Unique Features Solving Key Healthcare Challenges
- Real-time validation and enrichment against trusted registries and state license boards
- AI-driven deduplication and fuzzy record matching to eliminate duplicate provider entries
- Regulatory compliance engine with automated attestation tracking and audit trails
- Provider self-service portal with integrated workflows and identity verification
- FHIR and API-first architecture for seamless integration with payer systems, EMRs, and digital health apps
Real-World Impact
- 30% fewer claim rejections due to improved provider data accuracy
- 40% reduction in manual data maintenance costs
- 100% attestation readiness to meet CMS and No Surprises Act requirements
- Improved patient trust and satisfaction through accurate provider listings
With Provider Data Management, healthcare organizations gain more than just data accuracy—they gain control, transparency, and compliance peace of mind. Our platform doesn’t just clean provider data; it empowers operations, accelerates reimbursements, reduces regulatory risk, and enhances patient outcomes. In a world where every data point matters, Provider Data Management ensures your provider data works as hard as you do.