Coperor One MemberMeet the Challenge of Managing Health Plan Member Data
Coperor One Member consolidates and maintains health plan member data across the internal systems. Improve analytics, claims processing and member outreach by creating a high-quality member master file.
Across Systems. Across Companies. One Platform.
Member Data Quality Challenges for Healthcare Payers
Create a 360-degree view of member information from multiple internal systems and reconcile this with claims and encounter data from your provider network.
Systems are Moving to a Cloud Ecosystem
With the growth of cloud-based application systems, it is necessary for payers to meet the unique security, encryption and integration challenges created by a hybrid or cloud-native application architecture.
Evolving Data Privacy and Consent Regulations
CCPA, GDPR, and other regulations are evolving how data must be treated, even in areas outside of California and the EU.
Consumers at the Center of Healthcare
The challenges of today’s consumer-centric healthcare have exceeded the capabilities of traditional MDM vendors. Coperor E-MDM is ideally suited to the challenges of incorporating data from wearables, digital health devices and telehealth systems.
Enter Coperor One Member
Coperor One Member helps payer organizations continually improve member-related data and use it to improve operational efficiency and customer satisfaction in real-time.
Benefits to Health Plans
Integrate and Track Care Across All Systems
Lower Overall Cost-of-Care
Meet Compliance and Wellness Goals
Benefits to Members
Personalized Care for Optimal Outcomes
Maximized Care Coordination
Improved Access to Healthcare
A key performance indicator for third-party administrators is the number of claims that can be correctly processed automatically without human intervention. Coperor maximizes auto-adjudication rates for TPA’s by aligning Provider and Member data in claims to their master data profiles.
Enter Coperor One Provider and One Member
Reduce Claims Processing Costs
By eliminating manual review of claims that do not match on provider or member details, TPA’s are able to improve auto adjudication rates by 20% – 40%.
Claims data often contains alternate representations of provider and member identifiers that must be linked to master profiles to ensure that analytics are not skewed by avoidable duplication.
Collaborate With Risk-Bearing Groups
Claims data may contain information about members and their dependents. Coperor enables collaborative tools that ensure that insights into member data can be reconciled with provider group carrying shared risk.
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