insurance companies

Conduent Broadens Healthcare Payer Portfolio with New Innovative AI-Driven Provider Data Management Solution for Health Plans

Conduent Business Services, LLC

Conduent Business Services, LLC

New solution offers a single data source to keep network directories accurate and up to date in real time.

AI, automation and advanced analytics eliminate manual processes to authenticate and validate doctors’ information, reduce costs, improve compliance and provider and member satisfaction

FLORHAM PARK, N.J., May 24, 2023 (GLOBE NEWSWIRE) — Conduent Incorporated (Nasdaq: CNDT), a global technology-led business solutions and services company, today announced a new Provider Data Management (PDM) solution that brings health insurance companies a single, real-time data source to ensure the accuracy of their doctors’ directories. The PDM uses innovative AI and advanced analytics to collect, validate and communicate a doctor’s participation within a network, demographic revisions and other key data points. The company’s newest solution enables health insurance companies to improve claims auto-adjudication rates by reducing common data errors—such as incorrect addresses and speciality information—and enhances doctor and member satisfaction with

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Mercy Health seeks more reimbursement or plans to end Medicaid contract with Anthem

Mercy Health Jewish Hospital located in Kenwood.

Mercy Health Jewish Hospital located in Kenwood.

Bon Secours Mercy Health plans to terminate a Medicaid insurance contract with Anthem Blue Cross Blue Shield that covers 10,000 Ohioans unless the parties renegotiate a new contract by June 30.

The two companies currently have a contract that runs through 2024 to provide Medicaid insurance to patients at Mercy’s 21 hospitals in Ohio. But the health system has notified its patients if a new “fair” agreement isn’t made before June 30, Mercy’s Ohio hospitals will no longer be in-network for patients who receive Anthem’s Managed Medicaid the next day.

A representative for Mercy Health declined an interview request but in a statement, the company cited a 6.8% increase of operating expenses from 2021 to 2022 as reason for the need to renegotiate some of its contracts.

“Mercy Health contracts with health insurance companies (private payers), such as Elevance Health (otherwise known as

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