--Select a Product-- HMS MasterFile™ PxDx™ Affiliations™ Profiles™ Clinical Investigators™ MarketSim™ MedicareSim™ NewProductSim™ Data Integration™ ProviderOnline™ Web Services CompleteSpend™

Accelerating Claims Adjudication & Remediation

Clean provider data is needed to maximize first pass rates.

3-5% of all pended claims are caused by missing or inaccurate provider data. Data Integration Services cleanse, enhance, link, and maintain provider records to minimize the number of claims that kick out of the auto-adjudication process and to ensure that in-network providers are not mistaken for out-of-network providers.

One-stop-shop online access to provider information simplifies claims remediation and customer service.

ProviderOnline™ saves time and increases productivity by eliminating the need for multiple phone calls and web surfing to research non-participating providers.

Automate claims remediation.

Web Services enable business rules engines to automatically submit XML queries to the HMS MasterFile for missing provider information and to receive that information through XML responses, eliminating the need for manual intervention.

Better results at lower cost.

Through the combination of Data Integration Services™, ProviderOnline™ and Web Services we can deliver the accurate provider data needed to accelerate claims remediation and adjudication, while simultaneously lowering costs. By driving down B notice/W9 frequency, eliminating annoying customer service calls, and increasing first-pass rates, Health Market Science enables payers to turn accurate provider data into a source of improved profitability.