Health Insurance Exchanges
Comprehensive Data Collection and Processing Platform
End-to-end Data Management for the Exchange Provider Searches
A successful exchange strategy demands a proven approach to provider data and Provider Nexus delivers it.
We do the heavy lifting for you. Let Strenuus manage the complexities of collecting, organizing, and delivering actionable provider data sets. The Provider Nexus™ Platform provides consistent data output that frees your team to focus on what you do best.
With nearly 20 years of experience in the health industry, Strenuus’ dedicated team is driven to deliver the results that matter to you. Partner with a company that can handle all the tedious steps of managing provider data:
Your exchange users expect a quick and accurate search experience. Even though your provider network data comes from multiple health plans, your users get clear, concise, reliable provider results.
At Strenuus, our number one job is to ensure the final data you get is reliable. We have spent more than 10 years developing ActiveMatch™ technology, the industry leading provider match standard used by dozens of companies for their mission-critical needs.
Clients choose Strenuus for fast delivery, integrated business rule management, and the flexibility to adjust to their evolving requirements in real time.
Provider Nexus does not require additional IT infrastructure investment; all the processing is done on our secure servers that scale to fit your organization’s business needs.
Strenuus understands the sensitive nature of our clients’ data. Therefore, we have rigorous security standards to protect it. Authentication, role-based authorization, session security, secure file transfer… your data is yours. Our servers are located in highly secure, state-of-the-art data centers – offering 24/7 monitoring, biometric access, high level encryption, multiple levels of firewall and network protection and rigorous third party web vulnerability testing against viruses, malware threats, and exploits. Data center is fully PCI, SAS-70 and SSAE16 compliant.
Direct Data Acquisition
A history of working with the health plans means Strenuus has strong industry relationships built on trust.
- Establish data collection relationships
- Previously-supplied plan data "at the ready"
- Familiarity with contracting and data permission procedures
Flexible data specifications will outline the data elements required to fit your needs and support your exchange functionality.
Public Directory Data
If a carrier does not deliver data, Strenuus has a solution to keep your critical networks intact. Our proprietary technology enables us to gather any public directory data and merge it with other data feeds to deliver a comprehensive directory.
A comprehensive QA baseline is established based on health plans’ unique data structures and custom business rules for your organization.
Count Validation & Gap Analysis
- Normative reporting
- Harvest validation
- Carrier and client reports
- Previous submissions
- File consistency
Independent Data Validation
Independent data validation is an important aspect of ensuring data consistency. Harvested, directory-sourced data is an invaluable resource for validating network data that provides an unquestionably accurate and current comparison, that will distinguish your data in the marketplace.
An important consideration in managing user-ready data from multiple sources is ensuring data consistency. Strenuus uses monthly updated geographical data and latest best practices in standardization to prepare each set for merging into its master file.
Internal Multi-Step Processing
- Duplicate checking
- Domain mapping
ActiveMatch™, our proprietary dynamic matching algorithm, is designed to fit each client’s unique needs. Developed and refined over ten years, ActiveMatch allows for intelligent and fuzzy comparisons to ensure higher confidence matches than your competition.
- Variations or misspellings in provider or facility names
- Nicknames, abbreviations
- Multiple practice locations
- Differences in the presentation of specialties and addresses
- Accurate identification of providers at multiple locations
Accurately identifying unique providers is the key to delivering meaningful information.
- Physician type matching
- Hospital and facility matching
Complete, consolidated, provider dataset for your unique single or multi-payor provider directory and search portal needs.
IntegrationProvider Nexus API
Secure, state-of-the-art, cloud-hosted
- Provider Search
- Personalized Directories
- Network Ranking
The exchange client utilizing Strenuus-hosted APIs will have ready access to a senior software developer to provide code samples and assist with development around the API.
A fully-automated system for data receipt and processing allows for data deployments to happen continuously.
- Payor view for data review and sign-off
- Client view for optional data approval and business rule management
Regular updates ensure the data is always current and reliable and that information can be used by consumers to make meaningful decisions. Once approved by the data supplier and (optionally) the client, data is immediately available in production.
As your exchange grows, adding both products and members, ProviderNexus adapts to your needs without unnecessary investments on your end.
A successful project implementation involves interaction with Strenuus on a variety of fronts. A dedicated account manager will coordinate business rule implementation, data and application testing, status updates, and overall account support to ensure the highest level of service that is the basis for maintaining our strong client relationships.
ProviderNexus Directory Services can help you deliver the right data, whether your solution is single-feed or multi-feed. We will still do all the hard work from identifying the sources to matching and standardization and deliver you the data that is accurate, timely, and easy to load into your system.