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Occam for Health Plans

Precision member matching and mastering.

Health plans are big-data businesses powered by data from a multitude of sources. We make sure you can bring all the elements of a member’s record together, no matter where it comes from.

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Problem

Solution

Health plans have numerous line-of-business applications that get bombarded with updates from every direction - eligibility, claims, and members themselves - each with their own data quality issues and identifiers to keep track of.

Occam locates hard to find matches, ties individual records together with an enterprise identifier, and builds a golden record with most current contact information for each member across all sources.

How We Help

"The difference with Occam is it works right out of the box, without having to go pull a bunch of levers and do a bunch of tuning like you do with generic MDM tools. We didn’t need an army of consultants and tons of internal people working on it, which sped up the process a lot. I also like the pricing model - we need that kind of flexibility because members come and go."

Health Insurance customer

Foundational Benefits

Make your data whole

Shrink manual work by 80%

Solve patient data conflicts

Auto-link 95 to 98% of your records with Bulletproof Patient Matching even when information is missing or wrong, while filtering out false-positives like twins and junior/senior

Unresolved maybe matches mean incomplete data. When records lack enough information for an automated match, Occam’s Research Automation module fills in the blanks with data from our partner, LexisNexis

Generate a Golden Record for your patients with Master Data Management capability purpose-built for healthcare, without the expense and overhead of a giant MDM solution

Connect Member Data

Match records across line-of-business system and gracefully incorporate data from outside sources.

Standardize enrollment

Prevent duplicates by matching inbound enrollment transactions to member records already in your database and selectively update demographic information
Maintain best-known contact information

Coordinate member contact information updates and preferences across line-of-business systems.
Solve the orphan lab report problem

Match lab results even when there is little demographic information to go on
Enterprise Data Warehouse (EDW)

Improve the precision of your record matching to make sure no one is under-counted or over-counted in your enterprise data warehouse
Identify duplicate records in bulk

Proactively identify and resolve duplicate records in line-of-business systems rather than waiting for them to be discovered and reported one at a time.

How It Works

Integrate

Master

Manage

Get data in and out of Occam using the method that works best for you. Connect via API, flat-file, or HL7. Make Occam aware of the patients/members in your source systems, then get an Occam ID and Golden record in return, in real-time or batch.

Person records linked across two or more datasets usually contain conflicting values. Occam’s Master Data Management capability deals with conflicts in two ways: (1) As a Gatekeeper to prevent good data in your transactional systems from being overwritten with stale data (2) To generate a Golden Record representing the best information for a single patient across all the ways you know them.

Occam Research Automation shrinks the number of matches that require manual intervention, but there will always be matches that require human involvement. Occam’s task management workflow lets you prioritize the work that is left and makes identity decisions easier.

Want to see for yourself?

We'll show you Occam can make your data whole, using your use cases.