Ribbon Provider Data Management for Health Plans
Transform provider data infrastructure, unlock business efficiencies, and strengthen member experiences
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
Save significant time spend on data management
Centralize and streamline provide data workflows
Track and assess roster
quality at scale
Reduce work tickets and call center volume
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
Enrich
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.
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 ?
Flexible, scalable technology
Ribbon integrates with existing IT, data, and operations systems, and can easily scale as your workflows evolve
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
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
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
.png)