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The client is a leading international healthcare company headquartered in the UK, serving over 38 million customers across the world. They also provide health provision services and operate clinics, dental centers and hospitals in many other countries markets.
The client being from the insurance industry, was facing significant disruptions due to the evolving digital landscape and was under constant pressure to deliver better customer experiences and services at every touchpoint.
One of the major challenges faced by the health insurance industry is the lack of a comprehensive solution that covers provider management, contract management, claims verification, and payment management.
Datamatics' Provider Book of Record (PBoR) is a cloud-based framework that automates provider onboarding, credentialing, and contract management processes.
It provides real-time connectivity with multiple systems, including Policy Administration, Pre-Auth & Claims Management, Rules Engine, Provider Portal, and Finance systems. It is built on Dynamics 365 Service module and is customized to provide contract management and claim validation features.
Over payments resulting from incorrect procedure pricing
On contract and rate validation time
In claim processing time cycle
In credentialing time
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Datamatics is a Digital Technologies, Operations, and Experiences company that enables enterprises to go Deep in Digital to boost their productivity, customer experience and competitive advantage.