Conduent Broadens Healthcare Payer Portfolio with New Innovative AI-Driven Provider Data Management Solution for Health Plans
New solution offers a single data source to keep network directories accurate and up to date in real time.
AI, automation and advanced analytics eliminate manual processes to authenticate and validate doctors’ information, reduce costs, improve compliance and provider and member satisfaction
FLORHAM PARK, N.J., May 24, 2023 (GLOBE NEWSWIRE) -- (Nasdaq: CNDT), a global technology-led business solutions and services company, today announced a new that brings health insurance companies a single, real-time data source to ensure the accuracy of their doctors’ directories. The PDM uses innovative AI and advanced analytics to collect, validate and communicate a doctor’s participation within a network, demographic revisions and other key data points. The company’s newest solution enables health insurance companies to improve claims auto-adjudication rates by reducing common data errors—such as incorrect addresses and speciality information—and enhances doctor and member satisfaction with accurate, up-to-date information to avoid surprise bills and connect the patient to the right in-network provider.
The No Surprises Act mandates that health plans update their directories within 48 hours of changes to doctor information to avoid steep penalties. As health insurance companies continue to use manual, resource-heavy processes, they run the risk of noncompliance with the law. Conduent’s PDM solution leverages AI and automation to drive critical daily information updates, while dedicated call center professionals reach out to providers to verify missing or incomplete information.
“Health insurance companies struggle to maintain, verify and update their network directories. Our new innovative AI-driven data management solution eliminates complexity with a single source of truth to reduce incorrect claims payments, negative member ratings and unsatisfied doctors,” said Randall King, President, Commercial Solutions at Conduent.
The PDM is the newest addition to Conduent’s suite of end-to-end Healthcare Payer solutions to manage health plan administration. From member enrollment to claims management, the company’s software and services have helped health insurance companies engage members, meet compliance requirements, optimize cost of care and improve overall operational performance for more than 40 years. Conduent partners with 17 of the top 20 U.S. health plans and processes more than one billion healthcare claims a year. Visit the company’s site to learn more.
About Conduent
Conduent delivers digital business solutions and services spanning the commercial, government and transportation spectrum – creating exceptional outcomes for its clients and the millions of people who count on them. Through a dedicated global team of approximately 60,000 associates, process expertise, and advanced technologies, Conduent’s solutions and services digitally transform its clients’ operations to enhance customer experiences, improve performance, increase efficiencies and reduce costs. Conduent adds momentum to its clients’ missions in many ways including delivering 43 percent of nutrition assistance payments in the U.S., enabling 1.3 billion customer service interactions annually, empowering millions of employees through HR services every year and processing nearly 12 million tolling transactions every day. Learn more at .
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Trademarks
Conduent is a trademark of Conduent Incorporated in the United States and/or other countries. Other names may be trademarks of their respective owners.
