Coperor One Provider
Meet the Challenge of Maintaining Accurate, Up-to-Date Provider Data

 

One Provider consolidates and maintains accurate provider data across an ecosystem. Data completeness and quality improves its usability and reliability and enhances any internal or third-party data enrichment processes.

 

Click on a solution to explore further.

 

For Provider Groups  >

For Health Plans  >

For Third Party Administrators (TPAs)  >

Across Systems. Across Companies. One Platform.

Provider Challenges

Providers organizations often don’t have the systems to store, validate, and maintain the information required by their contracted health plans. They incur high administrative overhead for things like roster reconciliation with plans, credentialing, provider directory attestation, and provider network management. 

Enter Coperor One Provider

Effortless Regulatory Compliance

Manage all the necessary data elements and relationships required by state and federal regulations so you can focus on patients and quality outcomes.

Reduced Administrative Headaches

Attest to the accuracy of their data with contracted health plans on a regular basis. Eliminate roster processing and simplify regulatory attestations by generating the reports required by each plan.

Improved Provider Experience and Relationships

Reduce the time it takes to gather, validate, and communicate provider information to health plans.  Give provider relationship managers more time and resources to develop stronger relationships with providers instead of constant manual data oversight.

Coperor One Provider Supports the Largest Healthcare Market in the U.S.

Coperor One Provider is the backbone of the California state-wide provider directory utility – the most sophisticated and large-scale initiative of its kind anywhere in the world.

Payer Challenges

Healthcare payers have multiple systems that rely upon accurate provider information. These systems tend to exist independently of each other, and as a result, may contain conflicting, ambiguous, or outdated provider data. Avoidable manual processes, rework, and processing errors resulting from this poor-quality provider data impose a significant administrative cost and operational risk to any health plan.

Enter Coperor One Provider

Single Point of Control

Combine all provider data from multiple systems into a single integrated database to manage provider information quality and consistency from a central location. Each application preserves its autonomy without sacrificing control or visibility across the enterprise.

Ensure Data Privacy Protection

Ensure payers no longer rely upon data collection agencies for provider data validation. Your provider data needn’t be shared with data brokers, who you need to rely on to meet data collection and outreach requirements that you are liable for.

Collaborate With Partners

Manage the flow of information between your health plan and your contracted provider groups. Collaboration tools verify provider profiles and identify conflicts and changes. Execute formal attestation processes and roster reconciliation for Medicare, Medicaid, and commercial products.

Industry Model for Provider Data

Incorporate provider-related data into a single model from every interaction, internal system, market data and analytics platform. Ensure that your provider data model is future-proofed by leveraging our proven provider solution supporting the world’s largest provider networks.

Reduce Administrative Costs

Reduce the massive administrative overhead for payers due to manual processes, rework, and the fallout from processing errors.

Increase the Value of Your Data Enrichment Sources

Coperor provides the precision to enrich master data profiles by applying granular business rules regarding when internal data should and should not be amended by external enrichment sources. A common challenge for customers that purchase external reference data is how they can incorporate the valuable data without overwriting trusted internal data – Coperor solves this problem to maximize your investment in external data.

TPA Challenges

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 TPAs 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, TPAs are able to improve auto adjudication rates by 20% – 40%.

Improve Analytics

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 Payers

Claims data may contain information about provider network participation with various health plan products. Coperor enables collaborative tools that ensure that insights into provider data can be reconciled with plans and providers.
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