Healthcare data Management, Inc. Email Format

IT Services and IT ConsultingPennsylvania, United States2-10 Employees

Healthcare data Management, Inc. is an IT services and consulting firm headquartered in King of Prussia, Pennsylvania. It processes large volumes of employee healthcare claims data to generate insights that help clients take corrective actions and negotiate settlements with third-party administrators and pharmacy benefit managers. The company describes an Audit & Compliance service offering with Thomson Reuters that assesses both the financial accuracy of claims adjudication and the administration of benefits from a plan-design perspective.

Its core services focus on quickly identifying administrative errors and plan design issues, supported by the BenefitsAudit and BenefitsWatch offerings. Examples of common problems include other party liability, incorrect coinsurance levels, services paid for excluded benefits, billing and mis-coding, duplicate claims, and eligibility provided for terminated members. By pinpointing these areas, the service helps customers drive process improvements, uncover cost-saving opportunities, and confirm compliance with contract terms and plan provisions.

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