New Innovative AI-Driven Provider Data Management Solution for Health Plans

New Innovative AI-Driven Provider Data Management Solution for Health Plans

Conduent Unveils Provider Data Management Solutions for Real-Time and Accurate Network Directories

FLORHAM PARK, N.J., May 24, 2023 (GLOBE NEWSWIRE) -- Conduent Incorporated (Nasdaq: CNDT), a leading global technology-led business solutions and services company, has introduced an innovative Provider Data Management (PDM) solution aimed at addressing the challenges faced by health insurance companies in maintaining up-to-date and accurate directories of doctors. By harnessing the power of AI, automation, and advanced analytics, this solution offers a single, real-time data source to ensure the precision of doctors' information.

The PDM solution brings a host of benefits to health insurance companies, including improved claims auto-adjudication rates, reduced costs, enhanced compliance, and greater satisfaction among providers and members. It eliminates the need for manual processes by leveraging AI and automation to collect, validate, and communicate critical data points such as a doctor's participation in a network and demographic revisions. By minimizing common data errors like incorrect addresses and specialty information, the solution ensures accurate and reliable information, facilitating better decision-making and reducing the risk of surprise bills for patients.

To comply with the No Surprises Act, health plans are required to update their directories within 48 hours of any changes to doctor information to avoid penalties. However, manual processes often hamper compliance efforts, making it challenging to keep directories up to date. Conduent's PDM solution resolves this issue by leveraging AI and automation to drive daily information updates. Moreover, dedicated call center professionals proactively engage with providers to verify missing or incomplete information, ensuring data accuracy and completeness.

Randall King, President of Commercial Solutions at Conduent, emphasized the value of the PDM solution, stating, "Health insurance companies struggle to maintain, verify, and update their network directories. Our innovative AI-driven data management solution offers a single source of truth, simplifying complexities and reducing incorrect claims payments, negative member ratings, and dissatisfaction among doctors."

The PDM solution is the latest addition to Conduent's comprehensive suite of end-to-end Healthcare Payer solutions, empowering health insurance companies to effectively manage health plan administration. With decades of experience in the industry, Conduent has been instrumental in helping health insurance companies optimize their operational performance, comply with regulations, and deliver superior member experiences. Through its partnerships with 17 of the top 20 U.S. health plans and the processing of over one billion healthcare claims annually, Conduent has established itself as a trusted provider in the healthcare space.

About Conduent:

Conduent is a global technology-led business solutions and services company that leverages digital innovations to deliver exceptional outcomes for clients and millions of individuals worldwide. With a dedicated team of approximately 60,000 associates and a broad portfolio of advanced technologies, Conduent enables its clients to transform their operations, enhance customer experiences, improve efficiency, and reduce costs across various sectors, including commercial, government, and transportation. From processing nutrition assistance payments to managing customer service interactions, Conduent supports its clients' missions with unwavering commitment and expertise. To learn more, visit

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