Healthcare Data Management
Key Software, Inc. offers customized applications that are capable of in-loading, exporting and managing the following types of data
Key Software, Inc. offers customized applications that are capable of in-loading, exporting and managing the following types of data
Eligibility & Provider Data Management
- Efficiently managed more than 30 million providers and 45 million members by interfacing with 20+ health plans with just 3 data processors
- Experienced in handling various types of members & provider data in various formats, data balancing/reconciliation
- Adept in automation of data processing including error detection and correction
- Created a robust process including three-level support structure, data warehousing of raw data, maintaining detailed process logs and automated process notifications to stakeholders
Eligibility & Provider Data Management
- Efficiently managed more than 30 million providers and 45 million members by interfacing with 20+ health plans with just 3 data processors
- Experienced in handling various types of members & provider data in various formats, data balancing/reconciliation
- Adept in automation of data processing including error detection and correction
- Created a robust process including three-level support structure, data warehousing of raw data, maintaining detailed process logs and automated process notifications to stakeholders
Claims & Authorizations Data Exchanges
- Created automated applications to load & export more than 40 files from various health plans in various formats (X12 and proprietary formats)
- Automation of end to end process including downloading files from FTP, processing, error notification, reconciliation, export and uploading response files to FTP sites
- Misdirected claims handling through generation of paper claims or X12 responses
- Ability to reate members and providers on the fly using data from claims along woth NPPES fata to avoid using default IDs
Claims & Authorizations Data Exchanges
- Created automated applications to load & export more than 40 files from various health plans in various formats (X12 and proprietary formats)
- Automation of end to end process including downloading files from FTP, processing, error notification, reconciliation, export and uploading response files to FTP sites
- Misdirected claims handling through generation of paper claims or X12 responses
- Ability to reate members and providers on the fly using data from claims along woth NPPES fata to avoid using default IDs
Claims & Authorizations Data Exchanges
- Created automated applications to load & export more than 40 files from various health plans in various formats (X12 and proprietary formats)
- Automation of end to end process including downloading files from FTP, processing, error notification, reconciliation, export and uploading response files to FTP sites
- Misdirected claims handling through generation of paper claims or X12 responses
- Ability to reate members and providers on the fly using data from claims along woth NPPES fata to avoid using default IDs
Data Migration to and from EZ-CAP®™
- Successfully completed system migrations from EZ-CAP®™ to FACETS® and from other systems to EZ-CAP®™
- In-depth understanding of health care data and EZ-CAP®™ data structures.
EZ-CAP®™ is a registered trademark of Citra Health Solutions (part of Cedar Gate Technologies). FACETS® is a product of Trizetto (a subsidiary of Cognizant)
Data Migration to and from EZ-CAP®™
- Successfully completed system migrations from EZ-CAP®™ to FACETS® and from other systems to EZ-CAP®™
- In-depth understanding of health care data and EZ-CAP®™ data structures.
EZ-CAP®™ is a registered trademark of Citra Health Solutions (part of Cedar Gate Technologies). FACETS® is a product of Trizetto (a subsidiary of Cognizant)