Enclarity’s ProviderPoint Wins Product of the Year Award from Frost & Sullivan

“Health insurance payers are continuously challenged to maintain accurate and complete provider information,” said Matthew Guldin, a research analyst with Frost & Sullivan. “Further adding to this complexity is the fact that most health insurance payers store their provider information on multiple legacy systems that are incompatible with one another. This makes it nearly impossible for a health insurance payer to maintain an enterprise-wide master provider database.”

But Enclarity has met this challenge. The company takes existing provider demographic, key identifier, and other provider information from various sources, then analyzes the information using automated analytic and scoring techniques. If necessary, it can supplement it with semi-annual phone calls in order to provide the most accurate information.

Through its ProviderPoint solution, Enclarity can automatically purge, augment, and verify a health insurance payer’s provider records in real or near real-time frequency, or on a monthly or quarterly basis remotely. The benefits for a health insurance payer are many, including a reduction in pending claims, a reduced number of member and provider phone calls related to physician directories, and a drop in the number of paper checks that must be reissued to providers.

Fifteen of the nation’s largest health payers are now using ProviderPoint. According to Enclarity, one company that is using ProviderPoint has seen up to $10 million in administrative savings.

“By offering the ProviderPoint solution via a hosted or ASP method, Enclarity is able to ensure that all of a health insurance payer’s provider records are updated in a systematic and convenient fashion,” Guldin explained.

Frost & Sullivan presents Healthcare Information Technology Product of the Year Award annually to the company that has introduced a “significant” product into the market that provides a competitive advantage to its adopters.