Smart Data Solutions

Smart Data Solutions is positioned as a strategic partner in healthcare process automation and interoperability. According to the vendor, their Smart Data Solutions platform utilizes data and intelligent automation to digitally transform operations and deliver outcomes that aim to reduce costs, streamline workflows, and improve overall customer experience. This solution is designed to cater to healthcare payers, providers, TPAs (Third Party Administrators), PPO networks, and other healthcare organizations of all sizes. Professionals and industries such as health insurance providers, TPAs, PPOs, healthcare organizations, and medical billing companies are said to benefit from the features and functionalities offered by Smart Data Solutions.

Key Features

Form Capture: According to the vendor, the platform automates the capture of paper enrollment forms in any layout, including declinations, received via mail, fax, or email, aiming to eliminate the need for manual data entry.

Focus on What's Important: The vendor claims that the platform automates the front-end component of enrollment intake, allowing staff to focus on other areas and business needs. It is designed to accommodate the needs of TPAs of all sizes, with a user-friendly interface and minimal IT infrastructure requirements. Comprehensive support is provided.

Data Scheduling: Smart Data Solutions provides data scheduling capabilities for efficient processing and management of incoming data. According to the vendor, this feature allows for the automation of data capture and processing at specific intervals or on-demand, aiming to streamline workflows and improve efficiency.

Error Detection / Correction: The platform includes error detection and correction features to ensure data accuracy, according to the vendor. It is said to identify and flag errors in data capture and processing, providing tools and processes for error correction and validation.

Change Detection: According to the vendor, the platform includes change detection capabilities to identify and track changes in data. It is claimed to alert users to any modifications or updates in the captured data, helping to ensure data integrity and accuracy.

Digital Mailroom: The platform offers timely and accurate processing of claim and correspondence documents, according to the vendor. This feature is crucial for meeting filing requirements and routing documents to appropriate downstream processes.

Data Capture: Smart Data Solutions provides tools and solutions to capture, validate, and deliver data from various inbound documents, including standard claim forms, EOBs, enrollment forms, appeals, and more, as claimed by the vendor.

Claims Operations: The platform offers business process automation (BPA) for Health Plans, TPAs, PPOs, and other healthcare entities, according to the vendor. It is said to enhance staff or outsource workflows related to claims, appeals, enrollments, and correspondence.

Clearinghouse: Smart Data Solutions provides full clearinghouse services, including inbound claims processing, outbound remittances, and CAQH CORE compliant claim status and eligibility responses, as claimed by the vendor. This feature aims to facilitate seamless data exchange between payers and provider networks.

Interoperability: The platform includes an interoperability platform to enable streamlined processes and workflows between multiple trading partners, aiming to simplify the environment by reducing the number of connections and leveraging AI and automation, according to the vendor.