Digital. Dynamic. Dependable.
Streamline Provider Data Management to Enhance Efficiency
Maintain a well-organized directory of providers within the network by utilizing an AI-driven, Provider Data Management Solution, built on NewgenONE—a unified digital transformation platform. Deliver transformed member experience and ensure compliance adherence with marketing materials and the “No Surprises Act.
“Newgen’s data management solution enabled us to maintain a well-organized provider directory while drastically minimizing errors and strengthening relationship with our providers. The real-time data validation and reporting features have made compliance effortless.”
– CIO, Leading Healthcare Payer
Learn What Newgen Health Solutions for Provider Data Management Can Do for You
Robust Integration
Integrate with other applications and claims systems. Validate data against key data sources, such as Medicaid state files, license websites, SAM.GOV, preclusion lists, OIG, SSN death master, CLIA, PECOS, CAQH, NPPES, DEA, JCAHO, NPDB, and address validations.
Variance & Reconciliation Screening
Create variance and reconciliation reports for providers failing key integration checks. Initiate cases in credentialing and configuration workflows for review by your case workers.
Unified Data Management
Access centralized provider demographics, credentials, and contracts for consistency. Maintain a single source for records management.
Entity Relationship Maintenance
Ensure easy and hassle-free management of relationships between different providers. Enhance understanding of provider networks and affiliations through clear presentation.
Flexible Provider Hierarchy and Structure
Deploy a low-code, flexible structure adaptable to your existing or future structure plans. Meet existing NCQA, CMS, and state guidelines while accommodating additional field growth during expansion in future
Provider Update History
Access complete provider histories with a single search. View all provider documentation in one place. Review notes and completed credentialing and configuration cases for detailed analysis
Provider Lifecycle Management: Buy All-in-one Pack or Choose an Individual Solution
Explore Other Solutions for the Payer-Provider Journey
Claims Automation
Streamline claims with an AI-driven, low-code automation process
Provider Relations and Complaints
Enhance provider relationships while streamlining communications and driving a collaborative environment
SIU & FWA Case Management
Detect and address fraud while enhancing efficiency and ensuring compliance
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Frequently Asked Questions related to Provider Data Management (PDM)
Provider Data Management (PDM) in healthcare refers to the systematic process of collecting, validating, maintaining, and governing information about healthcare providers such as demographics, credentials, specialties, affiliations, and practice history. It ensures that provider data is accurate, up-to-date, and readily accessible for operations, compliance, credentialing, and contracting.
Newgen’s PDM solution centralizes all provider records into a single source of truth. It uses AI-based deduplication, machine learning validation, and automated compliance checks to ensure accuracy and consistency across systems.
Yes. Newgen PDM integrates with claims platforms, credentialing engines, contracting repositories, CRMs, and enterprise data warehouses. AI-enabled data matching ensures interoperability across legacy and modern systems.
By reducing claim denials, improving provider directory accuracy, and automating compliance checks, Newgen PDM delivers measurable savings. Calculate potential benefits with the Newgen PLM ROI Calculator.
