Healthcare Data Management

Key Software, Inc. offers customized applications capable of ingesting, processing, and exporting various types of data, which play a critical role in driving informed decisions, improving patient outcomes, and optimizing operations. Healthcare Data Management (HDM) is the backbone of modern healthcare systems, ensuring that medical data is collected, stored, organized, and utilized efficiently and securely.

Eligibility & Provider Data Management

Efficiently managed more than 30 million providers and 45 million members by interfacing with 20+ health plans with just 3 data processors.
Experienced in handling multiple types of members & provider data in various formats, data balancing/reconciliation
Adept in automation of data processing including error detection and correction.
Created a robust process including three-level support structure, data warehousing of raw data, maintaining detailed process logs and automated process notifications to stakeholders.

Claims & Authorizations Data Exchanges

Created automated applications to load & export more than 40 files from various health plans in various formats (X12 and proprietary formats).
Automation of end to end process including downloading files from FTP, processing, error notification, reconciliation, export and uploading response files to FTP sites.
Misdirected claims handling through generation of paper claims or X12 responses.
Capability to dynamically create member and provider records using data from claims and NPPES data, thereby avoiding the use of default IDs.

Data Migration to and from EZ-CAP®™

Successfully completed system migrations from EZ-CAP®™ to FACETS®™ and from various other systems to EZ-CAP®™
In-depth understanding of health care data and EZ-CAP®™ data structures.

Our Services Include

Data Collection

Gather patient information from multiple sources, including electronic health records (EHRs), wearable devices, and imaging systems. Our process includes collecting medical histories, diagnostic reports, lab results, and treatment plans to ensure comprehensive and accurate patient data.

Data Analysis

Leverage advanced analytics and AI tools to identify patterns, predict health outcomes, and enhance clinical decision-making.

Data Storage

Utilize cloud-based and on-premises systems to securely store both structured and unstructured data, ensuring compliance with regulations such as HIPAA and GDPR.

Data Security and Privacy

Implement robust encryption, firewalls, and access controls to protect sensitive information from breaches or unauthorized access.

Data Integration

Combine data from various departments, providers, and systems into a unified platform to create a comprehensive patient profile and streamline operations.

Why Choose Our Healthcare Data Management Services?

Effective data management is vital to the success of any healthcare organization. Given the increasing complexity of patient care and the heightened need for compliance, security, and actionable insights, partnering with a trusted expert is essential. Here’s why our healthcare data management services stand out.

Comprehensive Expertise Across the Data Lifecycle

Data Collection: Ensure accurate and secure capture of patient, clinical, and operational data from various sources.
Data Storage: Leverage cutting-edge cloud and on-prem technologies to provide secure, scalable storage solutions.
Data Integration: Consolidate data from disparate systems into a single, unified platform for seamless access.
Data Analytics: Apply advanced AI and machine learning tools to extract actionable insights for better decision-making.

Focus on Security and Compliance

HIPAA and GDPR Compliance: Our systems adhere to global and regional data protection laws to safeguard patient information.
Advanced Encryption: We implement robust encryption techniques to ensure data remains secure during storage and transmission.
Access Controls: Enforce role-based access to ensure that only authorized personnel can access sensitive information.

Tailored Solutions for Every Organization

Scalable Infrastructure: Whether you’re a small clinic or a large hospital network, we design systems that grow with your needs.
Customized Dashboards: Providing user-friendly, role-specific dashboards for clinicians, administrators, key stakeholders and decision-makers.
Specialized Use Cases: From population health management to revenue cycle optimization, we deliver solutions tailored to your unique challenges.

Cutting-Edge Technology

Artificial Intelligence (AI)

Utilize AI for document analysis, agentic pipelines, and machine learning workflows to

enhance automation and decision-making.

Predictive Analytics: Leverage predictive analytics to stratify patient risk and optimize perational efficiency.

Cloud Computing: Leverage cloud computing to deliver flexible, cost-effective data storage solutions and real-time access.
Interoperability Standards: Enable seamless communication between EHR systems, labs, pharmacies, and other healthcare entities.

Cost Efficiency and ROI

Elimination of Data Silos: Improve cost efficiency and ROI by eliminating data silos, unifying data systems to reduce inefficiencies and duplication.
Automation: Automate administrative tasks to streamline operations, saving time and resources.
Actionable Insights: Generate actionable insights to identify areas for improvement, reduce waste, and maximize ROI.

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Reliable Support and Collaboration

24/7 Support: Our dedicated support team is available around the clock to address your needs.
Training and Onboarding: Comprehensive training ensures your staff is equipped to maximize the value of our solutions.

We have worked with the following health plans in exchanging various data feeds (on behalf of our clients)