Community Health Choice is a local, nonprofit, managed care organization committed to helping improve the health and well-being of Texas residents. Founded in 1997, the company began by offering STAR Medicaid coverage to low-income children. Today, Community Health Choice proudly offers an array of affordable and no-cost health insurance plans to one of the largest provider networks in southeast Texas.
“We're all data nerds at heart, but our real goal is to do right by our healthcare providers and members. By getting the data right, Informatica helps us position ourselves to keep delivering the coverage and services Texans expect.”
Goals
- Provide better experiences while meeting regulatory requirements with a single view of providers and members
- Deliver fast and accurate payments to improve relationships with individual members and over 50,000 healthcare providers
- Bring speed and reliability to claims processes, particularly for complex cases that require input from multiple stakeholders
Solutions & Results
- Break down siloes between teams and data sources to gain a single view of healthcare provider information with Informatica Multidomain MDM
- Cleansed healthcare provider data, ensuring faster claim adjudication rates and timely claims processing across Medicaid and Marketplace product lines
- Accelerated claims approvals by 33% for over 50K healthcare providers in Community Health Choice’s provider network
- Create better data quality and trust rules to simplify claims approval process by utilizing Informatica Data Quality
- 59% improvement in accuracy of healthcare provider contact data, strengthening member relationships
- Improved trust in data across the organization, positioning member-facing teams to get closer to their contacts and build new relationships
Products & Services
Data Quality & Observability
Informatica data quality and observability ensures trusted, scalable data.
Address Verification
The world's leading solution for certified international address validation, correction, and standardization.
Cloud Application Integration
Integrate apps and data in real time with intelligent business processes spanning cloud and on-premises sources.
