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Healthcare

Solutions for health plans and third-party administrators.

BusyKeys delivers technology and services that help healthcare payers manage their most critical operational data. Provider directories, provider data quality, eligibility, claims, and the consulting expertise to tie it all together. We don't just sell you tools. We build solutions and manage them so you can focus on your members.

3.3M+
Lives Managed on Our Platforms
600K+
Providers Managed
12+ yrs
In the Payer Space
Cloud-Based
SaaS Platform
Built for Payers

We understand the challenges you face every day

Health plans and TPAs operate in a complex ecosystem of interconnected networks, vendors, regulators, and members. Provider data is never clean, compliance deadlines never stop, and the cost of getting it wrong hits your members directly. We've spent years solving these exact problems.

Provider data that's inaccurate, incomplete, or out of date across your directory and systems.

Quarterly state and federal compliance deadlines that require verified, audit-ready provider data.

Members who can't find the right provider because your directory doesn't reflect reality.

Multiple lines of business, markets, and networks that all need to be managed from one place.

Eligibility and claims data that flows through dozens of systems and needs to stay accurate at every step.

Vendor tools that require your team to do all the work instead of delivering managed solutions.

Provider Solutions

Manage your provider network from one platform

Your provider directory is only as good as the data behind it. These three solutions work together to keep your network data accurate, verified, and accessible to your members.

Member searching for a provider online

Provider Directory

A cloud-based provider finder that gives your members the simplest search experience on the market. Search by name, place, service, or specialty with highly relevant results. Fully customizable to match your brand - headers, footers, colors, fonts, and custom fields - without writing code. Supports multiple lines of business, markets, and networks. Integrates with your SSO. Regulatory compliant out of the box.

Healthcare data analyst reviewing provider data

Provider Data Management

A flexible enterprise data platform for collecting, analyzing, monitoring, and distributing provider data. Load and maintain provider-to-location relationships in a modern interface. Analyze roster changes across thousands of providers and locations in seconds with detailed reports showing exactly what changed. Hundreds of industry-standard and custom data points. API, flat file, and messaging-based integrations for getting data in and out.

Professional verifying provider information by phone

Provider Data Quality

Provider verification that goes to the source. We don't aggregate data and give you a confidence score. We contact provider offices directly - by phone, portal, and fax - and get definitive attestation of their information. Multiple verification methods give provider groups flexibility to respond efficiently. Full audit trail for state and federal compliance reviews. Our processes have helped health plans pass their toughest audits.

Data Hub Solutions

Keep your operational data accurate and connected

Eligibility and claims data flows through dozens of systems across your organization. Bad data at any point in the pipeline creates problems that are incredibly difficult to fix after the fact. Our data hub solutions catch issues early and keep everything in sync.

Healthcare administrator reviewing enrollment data

Eligibility Data Management

End-to-end management of your member eligibility data. We catch problems before they impact your membership - data issues that would be extremely difficult to unravel after the fact. Our team monitors, validates, and manages eligibility data so your plan can scale without the operational risk of bad data reaching your members.

Claims processing office with organized data

Claims Data Management

Claims data integration and management services that ensure your claims data is accurate, consistent, and flowing correctly across your systems. We help health plans architect and maintain the data pipelines that connect member, provider, and claims data from the ground up.

Healthcare team collaborating on strategy
Strategic Consulting

Healthcare expertise meets technical depth

Our team has lived inside health plan operations. We've helped organizations from startup phase through rapid market expansion, architecting technical integration environments and solving system integration challenges that other vendors can't handle.

Whether you need help standing up a new line of business, integrating a new vendor, or untangling years of data problems - we bring both the healthcare expertise and the technical depth to get it done.

What Makes Us Different

Solutions, not just software

Fully Managed

We don't hand you a tool and wish you luck. Our team manages the solutions on your behalf so your staff can focus on running the plan, not maintaining another platform.

Integrated Platform

Provider directory, data management, and data quality all work together as one platform. Data flows between solutions automatically, so you're not bridging gaps between disconnected tools.

Audit-Ready Compliance

Our provider data quality processes produce a full attestation trail. When auditors come, you have the documentation to prove your data is verified at the source.

White-Label Ready

The provider directory is fully customizable to your brand. Your members see your brand, not ours. Custom fields, language localization, and benefit plan configurations are all built in.

AI-Powered Automation

Where AI fits into healthcare operations

Our healthcare solutions are backed by BusyKeys' AI automation platform. These capabilities handle the high-volume, repetitive work that drains your operations teams.

AI Voice Agents

AI agents that place outbound calls to provider offices, navigate phone trees, interact with receptionists, and book appointments on behalf of your members. Handles hundreds of calls simultaneously without adding headcount.

Data Quality Automation

AI agents that continuously monitor provider data for inconsistencies, flag records that need attention, and help prioritize outreach to provider offices with the most critical data gaps.

Roster Processing

AI-assisted analysis of provider roster changes that identifies additions, terminations, and modifications across thousands of records, surfacing the changes that matter most for review and approval.

Is This For You?

You might be a good fit if...

Your provider directory doesn't reflect reality and members are calling to complain about inaccurate information.

You're approaching a state or federal audit and you're not confident your provider data will hold up.

You're scaling rapidly and your current data management processes can't keep up with growth.

Your current vendor sells you tools but you're doing all the work to operate and maintain them.

Your provider, eligibility, and claims data lives in disconnected systems that don't talk to each other.

Your operations team is spending too much time on manual data work instead of serving members.

Let's talk about your health plan

Tell us about your data challenges, your compliance deadlines, and the operational work that's consuming your team. We'll show you exactly how we can help.

Book a Consultation