SAN DIEGO February 13, 2006 Enclarity, Inc., an information management
and analytic software company focused on the healthcare market, today
unveiled ProviderPoint 2.1, the first proven solution to accurately,
automatically and systematically cleanse bad provider data and keep it
clean. ProviderPoint applies proven analytics technology to solve a problem
that until now has been attacked with labor-intensive, manual techniques.
The result is lowered costs and reduced risks for healthcare payers.
The announcement was made at the HIMSS (Healthcare Information and
Management Systems Society) Annual Conference & Exhibition held February
12-16.
"Our field tests with ProviderPoint have been excellent," said Daniel Day,
president and CEO of TC3 Health, LLC, a healthcare loss control and data
analytics company. "For years, the healthcare industry has tried with limited
success a number of approaches to solve the problem of provider data errors.
Cleaner provider data significantly improves our ability to detect fraud and
perform decision support for our payer customers. ProviderPoint, offers a
technological solution that exceeds our expectations."
Annually, the healthcare industry loses as much as $26 billion due to bad
provider data, through billing errors, check reissues, fines, fraud, and the
administrative costs incurred trying to fix the data and manually process the
claims. For example, reissuing checks returned as "undeliverable" cost
approximately $20 per transaction versus pennies for an auto-adjudicated
claim. However, in many health plans, the rate of auto-adjudication is less
than 50 percent, due in large part to errors in provider data.
"Every year, poor data quality in provider files costs healthcare payers money
and sabotages efficient operations," said Sean Downs, Enclarity's president
and CEO. "In response, our vision is that clean data is the key to making
healthcare more efficient. Taking the science of data perfected in aerospace
and banking, Enclarity has developed the way to make healthcare data more
reliable. With ProviderPoint, the problem of provider data errors can be solved
quickly and permanently."
A Technological Fix That Works
To solve the stubborn problem of inaccurate provider information, Enclarity's
executives used their extensive background in healthcare and leveraged
technology that helped create solutions that successfully automated the
aerospace and financial services industries. The result was ProviderPoint an
innovative software solution with a proven track record in finding the 50 to
70 percent of provider data that is inaccurate, and in fixing those errors
overnight.
A blend of the best of healthcare and analytic science, ProviderPoint works
by first "scrubbing" internal provider file data to identify inaccurate and
incomplete information. The files are then enhanced with information from
Enclarity's extensive provider data master file of more than 30 million records,
which includes provider information from both public and private external
sources. ProviderPoint is capable of correcting a half-million provider records
per hour. Then AcuSync", ProviderPoint's proprietary analytic technology,
verifies the accuracy of the data through its ability to "think" and bridge
between information to select the data that is accurate. From that point on,
records are updated regularly so that accurate, reliable provider information is
always available.
Operational Efficiency for Healthcare Industry
With Enclarity's solutions, healthcare payers gain the benefits of:
* Accuracy An accurate provider database that is constantly updated,
increasing provider directory accuracy and reducing the risk of fraud,
notification non-compliance, fines and penalties for paying sanctioned
physicians.
* Cost Savings Reduced costs for processing manual claims and payments
and re-issue check costs, as well as improved efficiency through increased
auto-adjudication of claims, network quality, reduction of customer and
provider call volume and handle time, and improved outcome reporting and
analysis.
* NPI Compliance A head start toward compliance with National Provider
Identifier (NPI) requirements, which will be mandatory in 2007.
"Until ProviderPoint, there was no systematic way for health payers to
maintain accurate provider data," Downs explained. "Most companies make
periodic attempts to manually "scrub" provider files several times a year by
deleting duplicates and fixing other errors in the records, such as removing
deceased doctors and updating addresses.
"Unfortunately, this labor-intensive process is time-consuming, costly and,
ultimately, ineffective. As soon as one record is corrected, another becomes
outdated. And, it's difficult for humans to look across all sources of
information to determine the most accurate, up-to-date record."
For one healthcare claims management company, Enclarity discovered that 77
percent of records contained incorrect or incomplete information and needed
to be fixed. More than 250,000 provider records were fixed overnight.
A regional health plan had its provider records scrubbed by Enclarity, which
found that 50 percent of those records required updating or correcting.
ProviderPoint is offered through a secure, Enclarity-hosted web service
(ASP), freeing customers from having to purchase, maintain or upgrade
software.
About Enclarity
Enclarity brings new solutions to fight an old problem for healthcare and
insurance payers: provider data errors. The company's software uses
advanced analytics and proprietary technology coupled with a massive
referential database and telephone verification to clean provider files,
assuring the data is accurate and current, increasing the productivity and
profitability of our customers.
From keeping provider records correct and up-to-date with integrated
solutions to helping businesses prepare for the National Provider Identifier
mandates, Enclarity dramatically improves the integrity and reliability of
healthcare data.
Enclarity, Inc., is a privately held company headquartered in Aliso Viejo,
California. For more information, visit www.enclarity.com.
Better provider data. Right now(TM)
Media Contacts:
Brian Teeter
Enclarity
949-330-6386
bteeter[at]enclarity.com
Joy Scott
Scott Public Relations
818-610-0270
joy[at]scottpublicrelations.com