Our Solutions

Smart Data Solutions provides complete front-end pre-adjudication solutions for hundreds of Payers nationwide. Whether you need basic services or a completely custom workflow, Smart Data Solutions offers a variety of solutions to meet your unique needs.
Consolidate vendor services Consolidate vendor services
Reduce costs with AI built automation Reduce costs with AI built automation
Increase quality of auto-adjudication Increase quality of auto-adjudication
Streamline your workflow & data endpoints Streamline your workflow & data endpoints
Digital Mailroom

Digital Mailroom

A mailroom is often the first touch-point for your claim and correspondence workflow. Having timely and accurate processing of these documents is crucial to meeting filing requirements and ensuring that everything is routed to the appropriate downstream processes.
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Data Capture

Data Capture

Whether it’s standard claim forms, EOBs, enrollment forms, appeals, or any other type of inbound document, Smart Data Solutions has tools and solutions to capture, validate, and deliver the data in the formats required.
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featured service

BPO Services

Business Process Outsourcing (BPO) is necessary to ensure quality service and improved efficiency for customers. Smart Data Solutions offers fully customized solutions to fit your businesses needs.
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Clearinghouse

Clearinghouse

Smart Data Solutions offers full clearinghouse services including inbound claims, outbound remittances and CAQH CORE compliant claim status and eligibility responses.
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Smart Data Stream Provider Portal

Smart Data Stream Provider Portal

The Smart Data Stream Provider Portal gives you immediate, simple, and low to no-cost access to submit and track claims directly through your web browser.
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Medical Claims Management / Routing

Medical Claims Management / Routing

Managing your networks can be a challenge but we can help. We have connections to your primary and wrap networks, as well as any bill review companies needed.
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P&C Workers' Comp

P&C Workers' Comp

Property and casualty payers have unique challenges and need to partner with a service provider that speaks their language.
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Enrollment Simplification

Enrollment Simplification

With solutions for paper capture and electronic file conversions, Smart Data Solutions offers a wide array of enrollment services to help streamline your workflow.
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1200+
SOWs written per year
7 TONS
of mail per week
500M
transactions annually
400+
Clients

Affiliations and Partnerships

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CLIENT STORY

Debbie Ziegler

“SDS performs all of our front-end services. This includes clearinghouse, scanning, imaging, OCR and mailroom. SDS also facilitates and performs ...”
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CLIENT STORY

Brian Janssen

“Smart Data operates as the EDI clearinghouse, paper claims and enrollment intake, and 834 enrollment hub for our commercial products. The development ...”
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CLIENT STORY

Matthew Estes

“SDS does EDI file translation mapping, eligibility checking, and routing to/from our business partners. SDS handles a lot of the heavy lifting for us ...”
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CLIENT TESTIMONY

Debbie Ziegler

Debbie Ziegler
Executive Director of Operations
“SDS performs all of our front-end services. This includes clearinghouse, scanning, imaging, OCR and mailroom. SDS also facilitates and performs automated routing to PPOs and networks, thereby ensuring that we expediently maximize client discounts. SDS also does pre-adjudication edits, such as member and provider matching. Finally, SDS provides custom IT services such as file format conversion and transfer for our Amerihealth and BCI partnership claims. SDS has a comprehensive service suite thereby allowing “one-stop shopping’ for all our front-end services. This is both cost-effective and much easier to manage. In addition, their IT aptitude allows us to fill in the gaps for one-off type projects. The process runs smoothly without much intervention. When we do have an issue they are quick to respond with a solution.”
“SDS performs all of our front-end services. This includes clearinghouse, scanning, imaging, OCR and mailroom. SDS also facilitates and performs automated routing to PPOs and networks, thereby ensuring that we expediently maximize client discounts. SDS also does pre-adjudication edits, such as member and provider matching. Finally, SDS provides custom IT services such as file format conversion and transfer for our Amerihealth and BCI partnership claims. SDS has a comprehensive service suite thereby allowing “one-stop shopping’ for all our front-end services. This is both cost-effective and much easier to manage. In addition, their IT aptitude allows us to fill in the gaps for one-off type projects. The process runs smoothly without much intervention. When we do have an issue they are quick to respond with a solution.”
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CLIENT TESTIMONY

Brian Janssen

Brian Janssen
VP, System Solutions
“Smart Data operates as the EDI clearinghouse, paper claims and enrollment intake, and 834 enrollment hub for our commercial products. The development and execution of these solutions is always done partnered with the business leaders to ensure meaningful improvements are achieved. Because of that, Smart Data is considered a valuable partner by business leaders. When we start a Smart Data initiative, as a corporate leader I do not have to worry about whether the outcome will be successful.”
“Smart Data operates as the EDI clearinghouse, paper claims and enrollment intake, and 834 enrollment hub for our commercial products. The development and execution of these solutions is always done partnered with the business leaders to ensure meaningful improvements are achieved. Because of that, Smart Data is considered a valuable partner by business leaders. When we start a Smart Data initiative, as a corporate leader I do not have to worry about whether the outcome will be successful.”
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CLIENT TESTIMONY

Matthew Estes

Matthew Estes
Chief Information Officer
“SDS does EDI file translation mapping, eligibility checking, and routing to/from our business partners. SDS handles a lot of the heavy lifting for us and allows us to focus on what we do best. No matter how complex the setup and routing, SDS has always been able to make it work for us.”
“SDS does EDI file translation mapping, eligibility checking, and routing to/from our business partners. SDS handles a lot of the heavy lifting for us and allows us to focus on what we do best. No matter how complex the setup and routing, SDS has always been able to make it work for us.”
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Recent Articles

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Smart Data Solutions Expands with New Global HQ, ...

Eagan, MN, December 10, 2024 – Smart Data Solutions (SDS), a leader in healthcare process automation and interoperability, ...
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How Automation is Redefining Outsourced Claims Management

Introduction When it comes to claims management, few areas of the healthcare lifecycle deliver greater opportunity and risk. ...
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Is Your EDI Gateway Putting You at Risk?

8 Quick Tips for Selecting an EDI Gateway and Clearinghouse Provider Partnering with the right EDI Gateway and Clearinghouse ...
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Why handle the heavy lifting of your claims workflow when a smart team enhanced by AI can?

Our tools, solutions, and continued research into new AI and machine learning processes help payers nationwide reduce costs, achieve greater process efficiency, and reduce turnaround times.

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