Ribbon Provider Data Management for Health Plans

Transform provider data infrastructure, unlock business efficiencies, 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 spend on data management 

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Centralize and streamline provide data workflows

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Track and assess roster
quality at scale

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Reduce work tickets and call center volume

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Improve member
“Find Care” experiences

Ribbon Provider Data Management solutions

Ribbon Automation
& Infrastructure

Ingest, standardize, and manage multiple data sources to create one source of truth for your organization 

Ingest and standardize

Automate ingestion and standardization of internal and third-party data sources to one, actionable schema

Process, clean, and resolve

Build custom processing logic to efficiently manage data at scale according to your business needs

Automate QA testing

Run quality assurance checks to continually monitor vast amounts of data and easily ensure data pipelines are running smoothly

Ribbon Enrichment
& Insights

Add new data modules, distinguish between high and low-quality data, and uncover actionable insights


Build a more comprehensive, accurate database by adding new data fields from Ribbon, increasing fill rates on critical provider information and adding contextual data like cost, quality, and more

Discover insights

Evaluate the accuracy of data at scale and support decision-making on data management processes using Ribbon’s machine learning models and custom reporting dashboards

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, scalable technology

Ribbon integrates with existing IT, data, and operations systems, and can easily scale as your workflows evolve

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Best-in-class directory data

Enrich your data with Ribbon’s robust suite of data assets, covering data attributes key to “Find Care” experiences, claims, and network configuration use cases

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Actionable insights

Understand the quality of provider data at scale with Ribbon Data Scoring and Reporting, 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