QNXT
Consistent administrative data synchronization for operations, reporting, and analytics
Together, Gaine and QNXT enable healthcare organizations to streamline member, provider, and claims data processing in a manner that enables consistency of core administration data − not only with QNXT but with all connected downstream systems. This consistency is critical for overall operational efficiency, reporting, analytics, and regulatory requirements.
The Challenge
QNXT customers need a data management solution that will ensure operational processes are as streamlined and automated as possible with the most accurate data being captured within the enterprise. Manual interventions to resolve data conflicts and issues are costly and ultimately lead to increased cost overhead and potentially incorrect processing.
The Solution
Coperor’s comprehensive data management platform allows for full identity resolution across multiple domains helping ensure data quality while also synchronizing that information alongside administrative and clinical transactional data across the QNXT's platform.
Extraction, cleansing, and standardization
Coperor extracts member, provider, and claims data from various QNXT modules using pre-built connectors and industry-standard APIs. This data is then standardized using Coperor's enterprise-grade Master Data Management (MDM) capabilities, ensuring consistency and accuracy.
Identity resolution
Using domain specific advanced matching algorithms resolves any duplication within QNXT that currently create inconsistencies in profiles.
Data enrichment and validation
Coperor enriches QNXT data by incorporating various reference sources and data from other application systems within the organization to ensure higher data quality, accuracy, and completeness.
Orchestration and activation
Coperor manages the flow of data between QNXT and other systems, ensuring real-time updates and synchronization. This allows for seamless data access and activation through Coperor's Integration Hub, enabling various downstream applications and analytics.
By implementing Coperor's solution, organizations using QNXT can achieve a significant improvement in data quality, operational efficiency, and overall performance, ultimately leading to better healthcare outcomes and cost savings.
Summary
Core administration for an organization is an essential requirement for maintaining business operations and continuity. As a backbone function, it is imperative organizations maintain this function to the best of its abilities.
Coperor enhances core administration by integrating member, provider, and claims data from various sources, ensuring data quality and integrity for systems like QNXT. It automates data processing to minimize manual intervention and provides real-time accessibility of processed data to downstream consumers. This comprehensive approach allows QNXT and similar systems to focus on their primary functions.
This strategy has a multitude of benefits including data quality, automation, reporting, and analytics. Having cost effectiveness in maintaining systems like QNXT drives improved profitability, minimizes member and provider abrasion, and allows maximized use of staff.
Implementing Coperor is straightforward. Organizations simply need to connect QNXT and other key systems handling member, provider, and claims data to the platform. The data is then mapped to Coperor's data model, enabling the activation of integration points and data
The Benefits
Accurate, up-to-date member information
The foundation of any QNXT implementation is properly structured core Member information with robust validation and always current data. This ensures all aspects of the enterprise - demographics, enrollment, benefits, member services, and claims processing are optimized for efficiency and improved automation.
Trusted provider data management
QNXT’s provider data needs to constantly be maintained for consistent operational processing of claims. In addition, that same provider data is often used for reporting, network analysis, provider directory, and a myriad of other business use cases. Coperor provides a holistic solution for the maintenance and upkeep of this data and ensures proper data quality is in place to support these initiatives.
Claims adjudication and analytics
Claims data processing forms the foundation for organizations using QNXT. A lower auto-adjudication rate leads to increased manual intervention, which can be costly. Coperor addresses this issue by reconciling claims data, ensuring key data points are accurate for processing and verifying that all claims requiring adjudication are present. This reconciliation process not only improves efficiency but also directly impacts claims analysis, which is crucial for organizations to monitor spending, patient populations, and clinical outcomes.
Improved operational efficiency and automation
An efficient QNXT environment relies on operational soundness and maximum automation for daily business processes. Coperor enhances this efficiency by implementing comprehensive data checks and balances. This approach ensures data quality and completeness, allowing organizations to maximize their QNXT throughput and streamline operations.
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