Multi-Million Dollar Opportunity for Health Plan and Hospital Administrative Savings
Portico Systems (Portico), the leader in Integrated Provider Management (IPM) solutions, announced today a new solution for provider and member identity management. Portico's Master Data Management (MDM) product is engineered to deliver an accurate, reliable and consistent integrated identity management platform.
The lack of consistent and accurate provider identification has led to proliferation of duplicate records as well as wrongful attribution of provider data elements within records. Industry studies and actual field experience have shown that as much as 5% to 15% of provider data is affected by these problems. These challenges negatively impact many processes and result in increase inbound customer service calls, a higher percentage of claims processing fallout, incorrect patient registry and directory files, and file maintenance re-work across multiple departments and systems. At an average cost of $15 per incident, the cumulative cost of all of these errors can reach up to millions of dollars per year.
With the passing of the Patient Protection and Affordable Care Act (PPACA) and American Recovery and Reinvestment Act of 2009 (ARRA), there is an increased need by health plans and hospitals to integrate large amounts of information that come from different systems that pertain to provider networks, provider services/clinical encounters, patient profiles and claims information. This intelligent weaving of multiple data files, that in the end, renders a more complete view of the episode of care is needed in order to improve care coordination, pay for performance programs, create Patient Centered Medical Homes (PCMH), and also enable accurate and timely provider reimbursement.
"Enhancing our ability to uniquely identify providers and members was a natural evolution of our best in class capability of making information operational across the healthcare enterprise," said Matias Klein, Senior Vice President of Technology at Portico Systems. "Portico's MDM product can be used as a standalone solution or as an integrated component of the Portico Platform. This flexibility enables customers to use the MDM product for complex data conversions as well as master record initiatives. Best of all, our existing Provider Information Management customers can use this proven, integrated technology to 'supercharge' their ongoing operational performance and data accuracy initiatives."
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