Animas Data Solutions (now Curatus), LLC, a developer of provider data management tools for Medicare, Medicaid and commercial health plans, today announced the release of ProviderLenz.
The company's flagship technology platform, ProviderLenz, applies big data and artificial intelligence disciplines to virtually eliminate demographic errors for member-facing online provider directories. Furthermore, all of the operational areas within a health plan that rely on accurate provider data, such as risk analytics, quality management, encounter reporting, claims administration, care management, and network development, can now be certain they have the most accurate information possible.
Inaccurate provider data is problematic for health plans everywhere because the information is so decentralized. ProviderLenz solves this problem as a technology-enable platform that taps into all known, but unlinked streams of provider data to, first and foremost, create the plan's continuously-curated 'Master Provider Index.' From there, all plan directories are kept up-to-date all the time.
ProviderLenz also automates the CMS-required process of surveying a health plan's contracted providers each quarter to update their information. Both the CMS Provider Preclusion Rule and Network Adequacy requirements are also automated features within ProviderLenz.
In addition to minimizing provider abrasion, ensuring compliance, and increasing member satisfaction, ProviderLenz delivers significant financial benefits to health plans, including:
- Reducing administrative costs,
- Closing crucial leakage points for quality and risk-related revenue, and
- Limiting vendor count for provider data management and governance.
“The current approach to solving the pervasive challenge of unreliable provider data places a heavy burden on the already-busy healthcare providers themselves to continuously inform payers of their often-changing demographic attributes,” explained Mark Fabiano, co-founder and CEO of Animas Data Solutions. “Providers communicate those details to one of several provider data clearinghouses, which helps to reduce their burden, but falls short of solving the problem. We developed ProviderLenz to capture these details from already-existing data streams and lakes, to then curate and enrich the data for each unique use-case within a health plan's various operational areas. This way, healthcare providers can stay focused on delivering high-quality care.”
A key differentiator between ProviderLenz and competing products is the Accuracy Confidence Level (ACL), a score that it generates for each particle of provider data. Using a sophisticated data-scoring algorithm, ProviderLenz rates each data particle (such as phone number, address, accepting new patients, specialty code, etc.) based on six key factors. This is important because an ACL score gives health plans a measure of confidence in the accuracy of the data for each and every provider in their network.
When a low ACL score is detected, ProviderLenz automates the process of provider outreach so low-confidence information can be validated or corrected, while minimizing the burden on the provider.
About Animas Data Solutions, LLC
Animas Data Solutions (Curatus) is a technology company that offers full-service provider data curation, enrichment, management, and governance to the Medicaid Advantage, managed Medicaid, and Health Exchange markets.
The company's ProviderLenz platform powers that automated dissemination of curated and enriched provider data in real-time and behind-the-scenes for ALL payer use cases based on a single 'source-of-truth' Master Provider Index. This means that all operational processes within a payer's organization are always utilizing the same and most up-to-date provider data available.
All this is achieved with a single vendor and with no changes to a payer's current IT infrastructure.
For more information, visit Curatus.com.