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Data Sheet: Provider Data Management Frequently Asked Questions

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Navigating the complexities of healthcare data requires a solution that prioritizes security, interoperability, and accuracy. This resource addresses the most frequently asked questions regarding the HealthEdge Provider Data Management platform, a cloud-native solution hosted on Microsoft Azure designed to serve as a single source of truth for health plans.

This document details how PDM empowers organizations to maintain accurate provider directories, streamline operations, and ensure regulatory excellence through the following technical capabilities:

  • Enterprise-Grade Security: PDM employs a security-first approach, featuring role-based access, AES-256 encryption for data at rest, Single Sign-On (SSO), and full compliance with HIPAA and HITECH regulations.
  • Seamless Ecosystem Integration: The solution supports broad compatibility through configurable APIs, allowing for real-time data synchronization with HealthEdge proprietary solutions (HealthRules® Payer, GuidingCare®, Wellframe) and as well as external Core Administrative Processing Systems.
  • Data Integrity and Compliance: To ensure high-quality records, PDM utilizes over 300 built-in quality checks, third-party validations (including NPPES), and adherence to FHIR standards for No Surprises Act compliance.
  • Configurable Workflows: Leveraging a low/no-code framework, organizations can tailor business rules for match/merge processes and data validation without extensive technical overhead, facilitating rapid implementation.
  • Scalable Migration: PDM facilitates smooth transitions from legacy systems via one-time full data loads followed by incremental, near real-time updates.

Download this FAQ to discover how Provider Data Management can optimize your operational efficiency, ensure data accuracy across your ecosystem, and support your digital transformation journey.