Ribbon Provider Data Platform for Health Plans

Transform provider data quality and infrastructure, lower operational costs, and strengthen member experiences

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62% of people don’t trust their health plan for accurate care options. With our AI-powered platform, health plans can ensure up-to-date provider information for improved business workflows and exceptional member experiences.

Solution key benefits

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Save significant time and resources on data management 

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Centralize and streamline provide data workflows

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Quickly scale into new markets and manage large volumes of data

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Track, assess, and improve data quality at scale

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Reduce work tickets and call center volume

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Improve member experiences finding care

The Platform

Data Assets

Ribbon Directory

Partner Data Marketplace

Data Management Capabilities

Data Integration

Accuracy Scoring

Master Data Management

Data Views

Ribbon Directory

The industry’s most comprehensive and accurate data asset on healthcare providers and facilities, from basics like address and insurance network, to detailed metrics like common procedures, affiliations, cost, quality, and more. Data is constantly compiled and refreshed from thousands of sources, and Ribbon AI models surface the most accurate data.

Partner Data Marketplace

Our growing set of industry data partners, like CareJourney, allows you to easily integrate additional powerful data attributes all on the Ribbon data platform.

Data Integration

Ribbon technology automatically ingests and processes multiple provider data sources into one, standardized database.

Accuracy Scoring

Ribbon AI models assess your provider data accuracy at scale, from 0% to 100%.

Master Data Management

One powerful database to store, maintain, manipulate, and trace changes over time - critical for compliance.

Data Views

Configure data into multiple views and subsets for different use cases, like directory or claims.

The health plan member journey

Without Ribbon

With Ribbon

Leila onboards to a new plan. She visits a new specialist recommended by her primary care provider. Unfortunately, the specialist is not in-network.

Leila onboards to a new plan, and quickly receives a call from an onboarding specialist to help her find in-network, high-quality providers. 

She searches her plan’s portal for another nearby specialist. After booking the appointment, she learns the provider has moved locations, and is now an hour away.

She uses her plan’s portal to search for additional care. She’s able to filter on key criteria, and find the right provider-match with up-to-date information.

Leila receives an unexpectedly high bill from the out-of-network visit, and is extremely frustrated. She decides the second specialist is now too far away, and puts off receiving care.

Because Leila received in-network care, her claims are processed easily and without denials or issues. 

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Technology that unlocks business value for health plans

Case Study

Save significant time and investment in data management 

Ribbon’s technology automates and scales data intake process for a leading health plan, achieving ~95% time-savings

Case Study

Improve member
“Find Care” experiences

Case Study

Drive member satisfaction and retention

Ribbon’s national payer-provider customer achieved a 99% post-visit CSAT score by leveraging Ribbon’s data

Why choose Ribbon for your provider data management ?

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Flexible, enterprise-ready technology

Ribbon integrates with existing IT, data, and operations systems, and is SOC I & II and HIPAA certified

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Expansive provider data assets

Enrich your data with Ribbon’s robust suite of data assets, including 99.9% of providers and facilities in the U.S., 6B+ claims, 1.7M unique service locations, and 85% of lives covered across all LOB

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Actionable insights

Understand the quality of provider data at scale with Ribbon Accuracy Scoring, easily identify data gaps, focus manual validation, and filter “bad” data

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Growing partner ecosystem

Expand the power of Ribbon with our vibrant partner community, including EHRs, cloud providers (AWS, Databricks), product integrators, and data partners

Dedicated partnership model

Ribbon experts work side-by-side with your team, configuring technology to unique business needs and ensuring solutions drive business impact from day one

Fast implementation and updates

Ribbon enables <48 hour data processing, both to ensure strong member experience and regulatory compliance

Insights & Resources

Guide: A health plan’s guide to provider data management

Consumer Survey Report: How health plans can use data to unlock better care

One-pager: Provider Data Management for health plans