Skip to main content

Unlock Greater Efficiency & Value with HealthEdge® Provider Data Management

Amid a rapidly evolving healthcare industry, the integrity and efficiency of Provider Data Management (PDM) systems are key to achieving operational excellence. HealthEdge® is at the forefront of solution development, offering a comprehensive Provider Data Management solution that exceeds current market demands. We designed this PDM solution to optimize business operations by ensuring the integrity of healthcare provider data across your organization.

4 Unique Features of the HealthEdge Provider Data Management Solution 

Many PDM tools available on the market are disjointed, characterized by using assorted point solutions and custom-built systems among health plans. The HealthEdge Provider Data Management solution offers unparalleled features that set us apart, such as:

  • Provider Master Identifier: Allows health plans to uniquely identify providers and organizations, tailoring to specific business needs and requirements. 
  • Data Mastering with Prebuilt Match and Merge Rules: Match-merge survivorship rules adeptly manage and maintain data from diverse channels, addressing and resolving conflicts efficiently. 
  • Low or No Code Framework: Leveraging a generative AI-enabled framework, the PDM enables easy setup, source channel mapping, and configuration of downstream consumer systems with minimal coding effort. 
  • Observability Dashboard: Offers a transparent view of provider data with valuable insights into processing status, duration, and data quality. 

Access the Full Value of Provider Data Management 

The HealthEdge Provider Data Management solution ensures no data loss, offering 100% coverage for provider demographics, user-defined types (UDT), and benefit network data. It also supports real-time provider Application Programming Interface (API) services for addressing any discrepancies in provider information. Our team ensured the PDM solution is highly configurable, aligning with customers’ master data identification as defined in HealthRules® Payer (if applicable). This enables your organization to streamline processes to enhance automation while reducing overhead costs and inefficiencies.

3 Features that Enhance Health Plan Capabilities 

HealthEdge’s PDM solution stands out not only for its differentiators, but for its comprehensive capabilities that optimize workflows, distributions, and integrations for health plans: 

  • Enrichment and Workflow Features: The solution provides data enrichment through validation checks and user-friendly workflows. It leverages a centralized framework with over 300 built-in quality checks and third-party validations, including National Plan and Provider Enumeration System (NPPES) and address standardization. 
  • Distribution and Integration Features: We offer configurable data distribution and native Core Administrative Processing System (CAPS) integration, including a self-service module for scheduling and delivering extracts, support for real-time API, event-based distribution, and seamless integration with HealthRules Payer. 
  • Platform Features: As a modern SaaS platform, the PDM boasts web-based workflows, high availability, unlimited scalability, seamless upgrades, role-based access, and a customer-extendable data model. 

As an organization, HealthEdge is not just joining in on the healthcare industry’s evolution—we want to actively help shape its future. The HealthEdge Provider Data Management solution exemplifies our commitment to innovation, efficiency, and reliability. By addressing the complexities of provider data management with progressive digital platforms, we’re empowering health plans to achieve operational excellence and deliver superior care. 

Do you want more information on how the HealthEdge Provider Data Management solution can help optimize our data sheet.