Gaine Technology
EZ-CAP

Comprehensive administrative synchronization for operations, reporting, and analytics

Together, Gaine and EZ-Cap enable healthcare organizations to streamline member, provider, and claims data processing in a manner that enables consistency of core administration data not only with EZ-Cap but with all connected downstream systems. This consistency is critical for overall operational efficiency, reporting, analytics, and regulatory requirements.

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The Challenge

EZ-Cap customers need a data management solution that will ensure operational processes are as streamlined and automated as possible and that they are consistently using the most accurate data being captured within the enterprise. Manual interventions to resolve data conflicts and issues are costly and ultimately lead to increased cost overhead and potentially incorrect processing.

The Solution

The Coperor Health Data Management Platform (HDMP) allows for full identity resolution across multiple domains to ensure data quality. It then synchronizes that information alongside administrative and clinical transactional data across the EZ-Cap platform.

Extraction, cleansing, and standardization

Coperor extracts member, provider, and claims data from various EZ-Cap modules using pre-built connectors and industry-standard APIs. This data is then standardized using Coperor's MDM capabilities, ensuring consistency and accuracy.

Identity resolution

Coperor uses domain-specific advanced matching algorithms to resolve any duplication within EZ-Cap that would otherwise create inconsistencies in profiles.

Data enrichment and validation

Coperor enriches EZ-Cap data by incorporating various reference sources and data from other application systems within the organization which ensures higher data quality, accuracy, and completeness.

Identity resolution

Coperor uses domain-specific advanced matching algorithms to resolve any duplication within EZ-Cap that would otherwise create inconsistencies in profiles.

Data enrichment and validation

Coperor enhances EZ-Cap data by integrating information from multiple reference sources and other internal systems. This process improves overall data quality, accuracy, and completeness.

Orchestration and activation

Coperor manages the flow of data between EZ-Cap and other systems, ensuring real-time updates and synchronization. This approach allows for seamless data access and activation through Coperor's Integration Hub, enabling various downstream applications and analytics.

By implementing Coperor, organizations using EZ-Cap can achieve a significant improvement in data quality, operational efficiency, and overall performance, ultimately leading to better healthcare outcomes and cost savings.

Summary

Core administration is essential for healthcare organizations to maintain business operations and continuity. As a critical function, it's crucial for organizations to optimize this aspect of their operations. Coperor enhances core administration by integrating member, provider, and claims data from various sources, ensuring data quality and integrity for systems like EZ-Cap. It automates data processing to minimize manual intervention and provides real-time accessibility of processed data to downstream consumers. This comprehensive approach allows EZ-Cap and similar systems to focus on their primary functions.

The benefits of using Coperor include improved data quality, increased automation, enhanced reporting, and advanced analytics capabilities. By optimizing the maintenance of systems like EZ-Cap, organizations can achieve improved profitability, reduced member and provider friction, and more efficient use of staff resources.

Implementing Coperor is straightforward. Organizations simply need to connect EZ-Cap and other key systems handling member, provider, and claims data to the platform. The data is then mapped to Coperor's HDX data model, enabling the activation of integration points and data activities.

The Benefits

Accurate, up-to-date member information

The foundation of any EZ-Cap implementation is properly structured core Member information with robust validation and always current data. This ensures all aspects of the enterprise - demographics, enrollment, benefits, member services, and claims processing - are optimized for efficiency and improved automation.

Trusted provider data management

EZ-Cap's provider data needs to constantly be maintained for consistent operational processing of claims. In addition, that same provider data is often used for reporting, network analysis, provider directory, and a myriad of other business use cases. Coperor provides a holistic solution for the maintenance and upkeep of this data and ensures proper data quality is in place to support these initiatives.

Claims adjudication and analytics

Claims data processing forms the foundation for organizations using EZ-Cap. A lower auto-adjudication rate leads to increased manual intervention, which can be costly. Coperor addresses this issue by reconciling claims data, ensuring key data points are accurate for processing and verifying that all claims requiring adjudication are present. This reconciliation process not only improves efficiency but also directly impacts claims analysis, which is crucial for organizations to monitor spending, patient populations, and clinical outcomes.

Improved operational efficiency and automation

An efficient EZ-Cap environment relies on operational soundness and maximum automation for daily business processes. Coperor enhances this efficiency by implementing comprehensive data checks and balances. This approach ensures data quality and completeness, allowing organizations to maximize their EZ-Cap throughput and streamline operations.

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