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LexisNexis Risk Solutions Collaborates with Gaine Healthcare to Solve Health Plan Provider Data Challenges

Payers can leverage top quality provider data seamlessly integrated into their internal workflows and business systems

01/28/2020

ATLANTA and SAN LUIS OBISPO — LexisNexis® Risk Solutions is collaborating with Gaine Healthcare to offer health plans a powerful and effortless way of maintaining more accurate and continually updated provider data, addressing the needs of various stakeholders within the payer organization.

The collaboration will allow payers to quickly assimilate robust provider data from LexisNexis® ProviderPoint and LexisNexis VHCP® and execute business and systems integration and resultant downstream actions through Gaine Healthcare’s Coperor Data Integration PlatformLexisNexis® ProviderPoint® is a proven, powerful, hosted solution that assists health plans with a systematic way to keep their provider information accurate and up-to-date while significantly reducing operating costs. Used by more than 70 health plans, including 8 of the top 10 in the U.S., ProviderPoint leverages over 3,000 authority sources, over 1.6 billion medical claims annually and a robust payer contributory database to offer a current and comprehensive provider database in the US. LexisNexis VHCP® is a hosted, crowd-sourced, real-time data management and analysis solution that optimizes data insights for payers designed to meet federal and state regulations for provider data accuracy.

Gaine Healthcare’s Coperor Data Integration Platform currently enables the nation’s largest healthcare payers to access new information quickly and manage multiple source systems records while reducing integration costs. Coperor is capable of ingesting data streams and executing business and systems integration resulting in downstream decisioning and action. 

“This is a collaboration between industry leaders who are passionate about solving for the complexities of provider data accuracy,” said Josh Schoeller, Senior Vice President and General Manager of LexisNexis Risk Solutions, Health Care. “Our data solutions and analytics pair perfectly with Gaine’s data management integration capabilities to generate a powerful impact on data integrity for payers.”

“Coperor allows payers to optimize their investment in ProviderPoint’s vast repository of provider data by reducing integration costs, and enabling assimilation of provider data into multiple internal systems with unrivaled precision and control” added Martin Dunn, CEO of Gaine Healthcare.

With the combined solutions, payers will receive the following benefits:
  • Leverage LexisNexis Risk Solutions’ provider data without the need to change existing operation or analytic systems. The service includes data cleansing, enrichment with validation, correction and augmentation, and regular monitoring for changes.
  • Maintain multiple views of providers to support differing needs across health plan operations.
  • Provide data services to simplify the exchange of information between systems.
  • Orchestrate the distribution of data updates to internal systems, business process owners and external trading partners.
  • Establish a central point of control for data governance as well as integration.

Inconsistencies and inaccuracies in provider data assets remain a costly and complicated problem for health plans. It’s vital that payers address the challenge systemically so provider data can be updated, integrated, and managed with ease. Through this collaboration, payers can close information gaps and seamlessly assimilate the data into their workflows.

About LexisNexis Risk Solutions
LexisNexis Risk Solutions harnesses the power of data and advanced analytics to provide insights that help businesses and governmental entities reduce risk and improve decisions to benefit people around the globe. We provide data and technology solutions for a wide range of industries including insurance, financial services, healthcare and government. Headquartered in metro Atlanta, Georgia, we have offices throughout the world and are part of RELX (LSE: REL/NYSE: RELX), a global provider of information and analytics for professional and business customers across industries. For more information, please visit www.risk.lexisnexis.com and www.relx.com.

About Gaine Healthcare
Gaine helps leading healthcare organizations, life sciences, and biotech companies leverage information as they strive for competitive advantage and operational efficiency. Gaine’s Coperor™ platform arms its clients with Information Agility™ which maximizes flexibility, minimizes cost and time-to-value, and eliminates the risks associated with implementing new systems, migrating existing systems, and integrating data from internal and external sources. For more information, please visit gainehealthcare.com.

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Yuliya Kutuzava
KNB Communications for LexisNexis Risk Solutions
ykutuzava@knbcomm.com
203.504.8230 X 131