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Infosys Healthcare "Provider Data Management" Distributed Application

Overview

The healthcare payers spend billions of dollars annually on provider data management with mixed results. The Centers for Medicare & Medicaid Services (CMS) reported, 49% of the provider office locations listed in the online provider directories reviewed, contained at least one error. Accurate provider data is critical for connecting patients with appropriate network care providers.

Provider data management distributed application is designed to build a seamless Payer – Provider network, that leverages a shared infrastructure, which can provide new efficiencies to payers and providers, and ultimately impact reconciliation efforts, labor costs, auto-adjudication rates & overall member experience.

Consistent real-time data sharing among payers to reduce administrative costs by 75%

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Infosys Provider Data Management (PDM) Distributed Application provides a pre-configured blockchain powered network to enable accurate and efficient provider data management and sharing. Currently, enterprise stakeholders typically collect demographic data in separate, independently organized systems. A review completed by the Center for Medicare and Medicaid Services determined that 52% of listed provider directory locations had a least one inaccuracy. This distributed application allows members to actively share data with the aim of reducing administrative burdens and inaccuracies, resulting in cost savings for payers.

Challenges & Solutions

Blockchain based network to create a provider data exchange—a cooperatively owned, synchronized distributed ledger to collect and share changes to provider data, starting with demographics. This collective source of data aims to streamline provider directory inefficiencies and relieve friction between providers and multiple payers.

A blockchain based PDM network ensures availability of accurate provider directory to all the health insurance subscribers, ensuring efficient claim processing without delays.

Blockchain based network allows members to actively share data with the aim of reducing administrative burdens, reduce costs and inaccuracies, resulting in cost savings for payers.