Best Verisys Alternatives in 2025
Find the top alternatives to Verisys currently available. Compare ratings, reviews, pricing, and features of Verisys alternatives in 2025. Slashdot lists the best Verisys alternatives on the market that offer competing products that are similar to Verisys. Sort through Verisys alternatives below to make the best choice for your needs
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Incredable
Intiva Health
9 RatingsIncredable is an all-in-one configurable credentialing solution that bridges the gap between healthcare facilities, providers, and administrators. The platform streamlines the entire credentialing process, from document management and compliance tracking to credential verification. Incredable ensures that healthcare professionals remain fully compliant and prepared at all times. Trusted across the healthcare industry, Incredable reduces administrative burdens, enhances operational efficiency, and fosters seamless collaboration among all stakeholders, allowing healthcare teams to focus on delivering quality care. -
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CredentialStream
HealthStream
161 RatingsCredentialStream® incorporates patented technology that provides everything necessary for requesting, gathering, and validating information about a provider, all to establish a reliable Source of Truth for downstream processes. With a modern platform that is continuously updated, along with best-practice content libraries and industry-leading data sets, CredentialStream stands out as the most comprehensive provider lifecycle management solution available. -
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MedTrainer
MedTrainer
238 RatingsMedTrainer accelerates and simplifies healthcare workforce education, compliance, and credentialing. MedTrainer’s natively built software platform provides a seamless user experience that helps healthcare organizations thrive in managing their workforce. Learning: A healthcare-specific learning management system (LMS) enriched with thousands of education courses and resources created by subject matter experts to satisfy regulatory, accreditation requirements, and provide continuing education credit. Compliance: A technology solution that combines incident reporting, document, and policy management, and highly customizable reports to improve compliance. Credentialing: An end-to-end credentialing capability with automation, workflows, and centralized data to simplify the process and reduce costly delays. From PSV to provider enrollment and privileging, everything is in one platform with complete visibility. -
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CredentialingSpectrum
Clinicspectrum
5 RatingsCredentialingSpectrum is a secured, cloud-based medical credentialing software for facility, payer and contract management. It is a healthcare credentialing system that simplifies the process and increases efficiency. CredentialingSpectrum is a one-click comprehensive automation system that makes it convenient and the best provider credentialing software available in the USA. -
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Modio Health
Modio Health
1 RatingModio Health OneView was developed by credentialing experts and physicians. It allows for easy, centralized credentials management for your entire healthcare provider team. OneView automatically collects information about providers such as NPI, DEA and license numbers. OneView helps you keep your team compliant while your providers can focus on providing clinical care. -
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NextGen Healthcare EHR
NextGen Healthcare
3 RatingsNextGen Healthcare is a leader in healthcare software and services that enables the transformation of ambulatory health care. NextGen Office (1-10 doctors) and NextGen Enterprise (10+ doctors) are smart electronic health record solutions that help ambulatory practices reduce the burden of documentation, improve clinical outcomes, connect to other health systems, increase provider and patient satisfaction, streamline revenue cycles, and foster healthier communities. -
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Certify
Certify
Certify offers an API-driven approach to credentialing, licensing, and enrollment tailored for payors, health systems, and fast-growing digital health enterprises. We provide essential insights that enhance the performance of clinicians, teams, and healthcare organizations alike. With our user-friendly one-click credentialing solution, you can create top-tier provider networks effortlessly. Our real-time, automated credentialing adheres to NCQA standards, making it easier to expand provider networks. We ensure continuous compliance through automated ongoing monitoring of your provider networks. By eliminating the uncertainties and administrative burdens of licensing, we enable you to expand into new markets without hassle. Join our network and expedite your reimbursement processes, allowing you to focus more on delivering care. Our streamlined approach facilitates cross-state licensure across all 50 states for any category of license, while also simplifying the payor enrollment process for providers entering new markets. Monitor your enrollment progress conveniently with our tailored dashboards, and utilize our superior methodology to refine, standardize, and enhance your provider data effectively. This comprehensive service not only supports compliance but also fosters growth in a competitive landscape. -
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Medallion
Medallion
Medallion is the first solution for healthcare companies to fully offload their clinician operations—state license management, payor enrollment, credentialing, and more—in one modern management platform. Since inception in 2020, Medallion has saved over 100,000 administrative hours for leading healthcare companies like Cerebral, Ginger, MedExpress, Oak Street Health, and hundreds more. -
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symplr Payer
symplr
Reduce expenses, break down data silos, and enhance outcomes for your members with a cohesive, automated provider data solution. symplr Payer serves as a reliable single source of truth for provider data, ensuring it is regularly reconciled and verified against primary sources. This solution significantly boosts data quality, accessibility, and transparency. Additionally, it alleviates provider frustrations by eliminating redundant requests for information. By utilizing symplr Payer as the central hub for provider data across the enterprise, payers can disseminate timely and precise information to various downstream systems. Our comprehensive and adaptable provider data management solution oversees all pre-contract and renewal contract negotiations. You can streamline and standardize your contracting workflows while meticulously capturing contract specifics such as sentinel events, trigger dates, configuration efforts, process steps, fee schedule information, and more. Furthermore, symplr Payer's innovative design enables your organization to effectively merge contracting and credentialing processes into one seamless operation. This integration not only simplifies management but also enhances overall efficiency in handling provider data. -
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CodySoft
Cody
The health care sector faces significant challenges due to the complexities of CMS and state regulations, which often lead to increased time and costs. Daily struggles with outdated practices and the constant fear of failing to comply with regulations impact the communications and compliance teams of health plans. It is essential to streamline and gain oversight of your organization's compliance initiatives along with the entire material development workflow. CodySoft® offers an innovative suite of web-based software solutions tailored specifically for the intricate landscape of health plans. This platform enables more efficient and cost-effective management of marketing materials aimed at both members and providers. It helps minimize compliance risks while enhancing accuracy and simplifies the handling of investigation issues. Users can access their dashboards through a secure online portal without the need for IT integration. The software also allows for the straightforward generation of reports needed for regulatory audits and performance metrics, with updates visible in real-time, enhancing overall operational transparency. In a world where effective communication is vital, such tools can make a significant difference in ensuring organizational success. -
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Credentially
Credentially.io
Credentially assists healthcare providers in reducing the organizational inefficiencies associated with credentialing and onboarding by automating. Employers and physicians can now spend more time caring for patients and improving patient safety. It takes Credentially customers 5 days to sign up, validate, and onboard clinicians. This compares to the industry average of 60 days. -
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CAQH
CAQH
CORE unites various sectors of the industry to speed up automation and enhance business processes that simplify healthcare for patients, providers, and health plans alike. By leveraging the most reliable source of provider and member information, CAQH empowers healthcare organizations to cut expenses, enhance payment accuracy, and revolutionize their business operations. In the rapidly changing healthcare environment, ongoing advancements in payment and claims processing are crucial. Healthcare providers and health plans nationwide rely on CAQH to gather and oversee professional data, verify primary sources, and keep track of sanctions. Consequently, this leads to more efficient administration, improved regulatory compliance, and superior management of provider information. Ultimately, the collaboration fosters innovation and ensures that all stakeholders benefit from a more effective healthcare system. -
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symplr Provider
symplr
symplr's provider credentialing software serves as a comprehensive solution for managing provider data, effectively reducing turnaround times and streamlining revenue cycles, all while ensuring that patient safety remains a top priority. This software simplifies the processes of data collection, secure access, reporting, and maintaining ongoing compliance, making it easier for providers, credentialing teams, and internal approval committees to manage their responsibilities. Users have experienced a significant 20% decrease in the time it takes to complete credentialing, with a remarkable 50% drop in the frequency of committee review meetings. By utilizing this automated and intuitive platform, organizations can efficiently collect, verify, store, and share vital provider lifecycle information and documentation in one centralized location, leading to both time savings and cost reductions. Additionally, the software includes a payer enrollment module that facilitates the enrollment of providers with payers, allowing for easy tracking of applications throughout the reimbursement process. With advanced automation capabilities, it gathers data from numerous primary sources and conducts automatic checks for expired or suspended licenses, as well as verifying against databases such as NPDB, DEA, and SAM, thus enhancing the overall efficiency and reliability of the credentialing process. Ultimately, symplr’s software transforms the way healthcare organizations handle provider credentialing, making it a crucial tool in the industry. -
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MSO for the Web (MSOW)
HealthStream
HealthStream supports MSOW as a legacy platform. CredentialStream is recommended for new customers. -
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Converge
Verge Health
Turnkey solutions for credentialing, privileging, and performance oversight revolutionize compliance, shifting it from a mere administrative burden to actionable insights. This proactive approach to safety extends beyond merely responding to incidents, striving for a comprehensive strategy that integrates safety, risk, and quality data. By sharing risk-related information, organizations can derive actionable insights that facilitate proactive decision-making aimed at achieving zero harm. Converge embeds robust analytics and business intelligence, delivering critical safety data and tools right at your fingertips. Users can easily report near misses, incidents, feedback, or commendations directly through the EHR system. Collaborating with your implementation manager is essential to determine the optimal timeline, team composition, and project scope tailored to your organization's needs. This framework integrates Mortality Review, Safety Rounds, and Patient Launch to identify potential risks before they escalate. Furthermore, the system ensures real-time connectivity with CMS work order systems, minimizing redundancy and enhancing resolution efficiency. Solutions are introduced in a manner that is easily digestible, ensuring all team members are equipped for success. Gradual implementation of platform modules allows for seamless integration, enabling organizations to adapt progressively to new systems as needed. This thoughtful approach not only enhances safety but also fosters a culture of continuous improvement and accountability. -
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RFX
RFX Solutions
RFX is a modern alternative to manual processes that manage regulatory compliance. Credentialing, compliance records, contracts and staff records are all at your fingertips with RFX. As a healthcare facility, you have tens and thousands of documents that are critical to your regulatory compliance. Manually managing documents is inefficient and prone to errors, leaving you exposed to risk. With system-wide role-based access, you can work seamlessly as a group. Use simple workflows that allow for unlimited storage, unlimited users and scalability. Achieve consistent survey readiness. Our intuitive and simple tools will help you maintain up-to date compliance logs, credentials, staff records, and contracts. Automatic notifications provide timely alerts, allowing for the review of documents, logs and agreements. Better compliance, cost management, and resource management. -
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I-Enroll
Santech
For numerous hospitals and healthcare practices, the onboarding of providers tends to be an extensive and cumbersome endeavor. The re-credentialing process can often resemble starting anew, which can be exasperating for providers, administrative personnel, and healthcare leaders alike; they increasingly recognize that poor provider data management adversely affects both patient care quality and the financial health of the organization. Regrettably, provider management solutions, whether external or internal, have seen minimal innovation over the past two decades. Many healthcare entities still rely on disjointed, labor-intensive paper processes and a reliance on informal knowledge for gathering, overseeing, and processing provider information. However, I-Enroll offers a transformative solution for organizations of all sizes, allowing them to convert fragmented provider management tasks into smooth, cohesive, and well-integrated systems. By implementing I-Enroll, various users and departments can collaborate efficiently, functioning seamlessly like a well-oiled machine. This innovation not only enhances operational efficiency but also ultimately leads to improved patient outcomes. -
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Silversheet
Silversheet
Discover the comprehensive credentialing platform designed to ensure your facility remains healthy and compliant. It simplifies labor-intensive tasks such as primary source verification and OIG monitoring, reducing the risk of errors and overlooked documentation in preparation for inspections. Say goodbye to the hassle of navigating through numerous paper files; instead, keep your credentials securely stored in the cloud, allowing you to access them anytime and anywhere. Our system will notify you of any missing or outdated credential documents through automatic reminders, ensuring you stay on top of compliance. Benefit from one-click verifications for medical licenses and certifications, and facilitate online reference requests with tailored questions. Additionally, you can implement ongoing OIG monitoring and NPDB Query logging seamlessly. By managing all credentialing tasks online, you can eliminate paperwork, effectively track providers' appointments and reappointments, and maintain detailed individual profiles that include contact information and summaries. This innovative solution not only enhances efficiency but also fosters a more organized approach to credential management. -
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TriZetto
TriZetto
Speed up payment processes while minimizing administrative tasks. With over 8,000 payer connections and established collaborations with more than 650 practice management vendors, our claims management solutions lead to a reduction in pending claims and decreased need for manual efforts. Efficiently and accurately send claims for various services, including professional, institutional, dental, and workers' compensation, ensuring prompt reimbursement. Tackle the evolving landscape of healthcare consumerism by delivering a smooth and transparent financial experience. Our patient engagement tools enable you to facilitate informed discussions around eligibility and financial obligations, while also lowering obstacles that could affect patient outcomes, ultimately fostering better healthcare experiences. -
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Axuall
Axuall
We link healthcare systems, staffing agencies, and digital health organizations to a comprehensive range of data, delivering valuable insights that enhance network planning, analytics, and reporting, while significantly streamlining the processes of onboarding and enrollment through provider-enabled digital credentials. Axuall empowers healthcare professionals to take charge of their career identities, facilitating smarter and more effective network planning, credentialing, privileging, enrollment, and deployment across healthcare systems, staffing firms, telehealth services, and health plans. By removing obstacles and delays that hinder patient access and contribute to clinician burnout, Axuall aids in capturing millions in additional revenue while ensuring the quality of care remains high. Furthermore, Axuall offers a holistic approach to workforce intelligence, featuring a suite of integrated components designed to promote better decision-making and expedite provider onboarding processes. Ultimately, the platform drives enhanced and expedited decisions regarding human capital management, thus improving overall operational efficiency. -
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EddyCore
Eddy
EddyCore is a cloud-based, self-service software solution designed for credentialing, privileging, and enrollment, aimed at streamlining processes for both healthcare organizations and providers while conserving precious time and resources. Our cutting-edge software and services integrate seamlessly with EddyOne, facilitating the effortless gathering of provider data. With an unmatched implementation speed, we offer services that make the transition to our software straightforward and efficient. Users can delegate verification and enrollment responsibilities while keeping track of tasks in real-time, ensuring nothing falls through the cracks. The platform is free from modules and feature limitations, delivering the full capabilities of Eddy immediately upon access. Additionally, you can create an unlimited number of non-provider accounts without incurring extra charges and conduct multiple primary source verifications with just a click. EddyCore has been crafted by experts in credentialing and enrollment to simplify the responsibilities of those managing provider credentialing and enrollment, making it an essential tool for healthcare professionals. Ultimately, our mission is to enhance efficiency and ease in the credentialing process so that providers can focus more on patient care. -
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Credential Sentry
Credential Sentry
$30 per user per monthMonitor the professional licensing status of your employees and business associates effortlessly to remain updated on any potential license suspensions, safeguard your organization's reputation, and prevent unnecessary financial setbacks. Ensure that you only engage fully licensed professionals, be they contractors or employees, to protect against both financial loss and damage to your reputation. The process of automating the verification of licenses for both contractors and employees has been streamlined significantly: with just a few clicks, you can access up-to-date credential information, screening as many names as needed simultaneously. Enhance your professional license verification process by validating an unlimited number of records as often as required, which not only saves time and money but also enhances overall productivity. This proactive approach not only fortifies your hiring practices but also establishes a robust framework for compliance and due diligence in your organization. -
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RedVector LMS
Vector Solutions
RedVector, a prominent brand under Vector Solutions, stands out as a top provider of online training and educational resources across a variety of sectors, such as architecture, engineering, construction, industrial, facilities management, and IT and security. Their technological offerings encompass an advanced learning management system, tools for incident tracking, management for licenses and credentials, competency assessments, and a plethora of additional features. The RedVector LMS is designed as a comprehensive learning and talent management system tailored to address the needs and obstacles faced by contemporary learners. This platform, paired with RedVector’s superior training materials, equips organizations with a powerful solution for overseeing safety, compliance, licenses, and credentials, among other important functions. Known as RedVector, this brand is an integral part of Vector Solutions, which serves businesses with AEC education and software, while RedVector remains dedicated to delivering AEC educational resources to individual learners. With a commitment to innovation and excellence, RedVector continues to enhance its offerings to better serve its diverse clientele. -
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MD-Staff
Applied Statistics & Management
MD-Staff offers a cloud-based, AI-powered credentialing software solution that is both intuitive and supported by more than three decades of innovation. With a global clientele exceeding 2,000, MD-Staff streamlines the credentialing process, monitors clinical privileges, and enhances patient safety initiatives through automation. This reliable software is complemented by tailored customer service to meet the specific needs of its users. The Aiva™ Credentialing engine within MD-Staff employs advanced AI and automation techniques to significantly reduce application processing times while identifying problematic practitioner files. Additionally, MD-Staff facilitates primary source verifications via web crawlers, Pronto reference checks, and robust integrations with key primary sources including NPDB, OIG, and SAM. The platform's privileging module boasts an easy-to-use drag-and-drop interface, making the creation and management of both standard and specialized privilege delineation forms straightforward. Overall, MD-Staff stands out as an invaluable tool for healthcare organizations looking to optimize their credentialing and privileging processes. -
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ShiftKey
ShiftKey
FreeWhen facilities are prepared to meet their demands and independent professionals have the flexibility to determine their work locations and schedules, a powerful environment for advancement is created. ShiftKey bridges the gap between licensed professionals and facilities nationwide. Our innovative technology offers autonomy and foresight, alleviating stress, enhancing visibility, and creating a scalable, data-driven approach to workforce management. Professionals can bid exclusively on assignments that interest them and work at their own rhythm. They receive timely notifications about enticing new roles, choose their projects, and get compensated shortly after their work logs are validated or opt for weekly bank deposits. Our user-friendly dashboard allows businesses to post job opportunities for independent credentialed professionals while acquiring vital data to maintain a competitive edge. There are no bureaucratic hurdles, no hidden charges, and complete clarity throughout the process. With the ability to make choices that align with their personal lives, independent professionals experience noticeable improvements in their earnings, overall well-being, and their connection to work. This empowerment fosters a dynamic environment that encourages both personal and professional growth. -
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SKYGEN's Provider Data Management (PDM) is a responsive solution designed to enhance the management of provider networks and foster better relationships between healthcare payers and providers. This platform not only boosts the capacity of payers to construct effective provider networks but also elevates satisfaction levels for both providers and members while reducing administrative expenses. By leveraging cutting-edge technology, PDM addresses the demands of contemporary, tech-savvy healthcare participants. It streamlines contract acquisition costs through swift, efficient, and paperless provider recruitment and supplemental network rentals. Additionally, the solution lowers credentialing costs and enhances provider satisfaction by facilitating online credentialing processes. By automating provider self-verification, it eliminates costly outreach efforts and ensures that provider data remains accurate and verified for online directories. Ultimately, SKYGEN enables dental and vision connectivity solutions that empower clients to embrace the future with confidence, utilizing technology that fosters unmatched efficiencies and effectiveness in their operations. This innovation positions healthcare organizations to thrive in an ever-evolving landscape.
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Model N
Model N
Model N offers a comprehensive platform that enables organizations to enhance their revenue while modernizing Sales, Marketing, Channels, Finance, and Legal workflows. By utilizing Model N’s revenue management tools, businesses can transform isolated, tactical operations into cohesive end-to-end revenue processes through the power of automation and intelligent insights. Revenue Cloud effectively connects front-office and back-office functions, creating a consolidated system of record for all revenue-related activities. This platform empowers clients to effortlessly configure and quote intricate products, swiftly finalize complex contracts, and gain access to accurate, real-time channel data, enhancing transparency within their channels. Furthermore, it streamlines the management of incentive programs, helping to prevent overpayments. Additionally, Model N’s Rebate Management feature enhances channel engagement, leading to improved revenue optimization. Ultimately, this holistic approach allows companies to achieve greater efficiency and effectiveness in their revenue generation efforts. -
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Madaket
Madaket Health
Reclaim precious hours in your day and save millions with our innovative automated solutions. Connect effortlessly with essential stakeholders—providers, payers, and partners—while gaining access to real-time, precise data that ensures seamless care delivery. We simplify the intricate web of thousands of payer connections, allowing you to initiate quick and straightforward enrollments with ease. Experience the unparalleled capabilities of the cloud like never before. Our centralized command system enables you to manage, store, and share provider information in real-time, ensuring connectivity wherever necessary. Verification of providers is now a hassle-free process; simply make a request, and our platform will expedite it for you, enhancing your operational efficiency. Let us help you streamline your workflow like never before. -
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Float Care
Float Care
Streamline your operations and reduce costs with tools that encompass healthcare workforce scheduling, secure messaging, credentialing, and additional services. Centralize and manage all medical credentials in a single location for utmost convenience. Receive notifications regarding new requirements and track credentials that are approaching expiration dates. Float Care ensures your referrals are fully automated, successfully completing all handoffs each time. By connecting essential care providers, Float Care automates referral processes, guaranteeing that patients secure appointments before they leave the facility. Enhance collaboration among provider care teams to improve patient outcomes. Managing more than 150 different credentials for healthcare professionals, including nurses and doctors, can be overwhelming, but Float Care’s credentialing platform simplifies the process by providing easy access to all records, licenses, certifications, and more, thus facilitating better compliance and management of credentials. This comprehensive solution ultimately saves valuable time and resources for healthcare organizations. -
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Consensus Signal
Consensus Cloud Solutions
Consensus Signal offers instantaneous notifications for health events, ensuring that providers and care teams are connected no matter where patients are being treated. In collaboration with Secure Exchange Solutions, a top-tier event alerting provider, we enhance our reach across electronic health records (EHRs) and provide access to a comprehensive national directory for easily identifying the appropriate healthcare provider for each individual. This partnership allows us to send alerts directly into the workflows of healthcare providers' EHR systems without the need for expensive interface setups. Additionally, there’s no requirement to upload patient lists or even possess an EHR, as we can seamlessly deliver user-friendly alerts directly to existing email platforms. With the introduction of the new Conditions of Participation (CoPs), compliance for hospitals participating in Medicare and Medicaid is now mandatory, which includes psychiatric hospitals and Critical Access Hospitals (CAHs), and requires these institutions to electronically notify primary care providers about patients’ admissions, discharges, or transfers. As a result, this system not only streamlines communication but also enhances patient care coordination across various healthcare settings. -
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Over 500 healthcare professionals trust their enrollment processes to WCH Service Bureau. Try this all-in-one tool to keep track of your participation contracts, insurance panels, revalidations, and so much more. CredyApp allows you to allocate tasks among your staff based on specifics and complexity. CredyApp features make managing credentialing processes of any size and employees assigned to clients' workflows easier. All-in-one client portal: Portal designed for profile maintenance, insurance status, and document management. Credentialing made easy - Keep track of client's insurance renewal dates. CredyApp makes it easy for you to streamline your enrollment process, whether you're a seasoned credentialer or a novice.
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CredentialMyDoc
HealthStream
CredentialMyDoc is a web-based software that makes it easy to enroll providers and create credentialing documents. It streamlines data entry and validation, reduces errors on forms, streamlines billing and increases provider satisfaction. -
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Verifiable
Verifiable
A cutting-edge provider data engine that offers instantaneous verifications and robust automation, streamlining the processes of credentialing and managing provider networks. This solution serves as a centralized hub for overseeing all provider data, workflows, onboarding, and network management tasks, along with various other related operations. By replacing traditional manual verification methods with automated solutions, organizations can enhance efficiency, reduce costs, and improve compliance by minimizing the risk of human error. Experience rapid verifications and sophisticated network oversight tailored to the specific requirements of your business. The system features advanced credentialing and compliance tracking that alerts you to potential gaps before they escalate into significant problems. Ensure that you have the most precise and current data available through our unique real-time lookups, conveniently accessible via an API designed for seamless integration. Ultimately, this healthcare API not only meets your needs but also provides a user-friendly experience, allowing for customization and effortless integration with your existing systems and workflows. Enjoy the benefits of having a powerful tool that enhances operational efficiency while maintaining high standards of accuracy. -
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Hyperstack
Hyperstack Inc.
$0/month Hyperstack is a credential platform used by some of the world's top universities, non-profits, accelerators, online Ed-tech and training providers, medical / health care organizations, certification bodies, etc to issue certificates and badges to recipients. -
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EchoOneApp
HealthStream
HealthStream supports EchoOneApp, a legacy platform. CredentialStream is recommended for new customers. -
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Entrust Instant ID
Entrust
Design, issue, and manage credentials anywhere, anytime. Entrust Instant ID lets you create, issue, and manage secure IDs and credentials. It empowers organizations to meet a wide range of application requirements, from basic photo IDs to high-assurance credentials. Plus, you can easily scale from a single workstation or user to a multiworkstation, enterprise-wide application with more functionality. -
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Health e(fx)
HealthCare Impact Associates
The employer mandate of the ACA is intricate, placing an unequal strain on HR benefits teams tasked with adhering to the regulations. Additionally, the presence of state-level individual mandates adds further complexity to the landscape of employer health reform, which is subject to continuous change. Health e(fx) streamlines ACA reporting by providing tailored services and unique solutions designed to meet diverse needs. Our dedication to client support is a core aspect of our identity. This commitment is a significant factor in why our software is trusted by 75 companies listed in the Fortune 500. Built on extensive experience in health reform, Health e(fx) has established itself as the leading technology solution for the Affordable Care Act (ACA), currently aiding over 22.5 million individuals. As the pandemic and accompanying staffing difficulties persist, coupled with a new pro-ACA administration, navigating ACA and state mandate reporting is increasingly challenging for employers, as well as the benefits, payroll, and tax professionals who assist them. Throughout these changes, Health e(fx) remains proactive and adaptable, ensuring that we meet the evolving needs of our clients effectively. -
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DRG Claims Management
DRG Claims Management
It is accurate to assert that "not all DRG vendors are equal." Although their marketing strategies may be similar, these vendors generally fall into two categories: those that cater primarily to provider hospitals and those focused on detecting overpayments for health plans and payers. Much like how attorneys often concentrate on either defense or plaintiff cases, auditing vendors tend to specialize in the distinct needs, cultures, and priorities of their respective clients. Within the realm of payer-focused vendors, a diverse array of strategies for DRG auditing and overpayment detection exists. Our service offerings also include a dedicated physician review team that generates clinical validation findings, specifically addressing cases where identified issues stem from unsubstantiated clinical diagnoses made by treating physicians, which goes beyond the capabilities of coders. Our findings consistently demonstrate that our coding compliance model yields verified savings, contributing to enhanced financial efficiency for healthcare providers. Thus, selecting the right vendor can significantly impact the financial health of both hospitals and payers alike. -
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ProviderTrust
ProviderTrust
We provide a comprehensive platform that encompasses everything from healthcare license verifications and OIG exclusion checks to enterprise compliance and eligibility monitoring. By enriching both primary source data and our clients' records with unique identifiers, we uncover and validate issues that are often overlooked, ensuring you are informed of concerns you might not discover otherwise. Our mission has always been to excel in healthcare monitoring beyond all competitors, which required us to meticulously aggregate, cleanse, and enhance primary source data until our proprietary dataset surpassed the intelligence of the original sources. Our method is designed to blend advanced automation with human oversight, enabling us to analyze and interpret a vast array of primary sources across various states and healthcare sectors to ensure accurate match verification. As a result, you receive only precise-match outcomes, offering you peace of mind in your operations. Looking ahead, the evolution of enterprise compliance and eligibility monitoring lies in providing immediate access to critical insights precisely when and where you require them. Our commitment to continuous improvement ensures that we stay ahead of the curve in delivering these essential services. -
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SEC3URE Ethos
IntelliCentrics
Establishing a reliable environment is crucial for providing top-notch care. Caregivers and staff must be able to make informed decisions regarding patient treatment, a task that becomes challenging without access to accurate information and dependable systems. This necessity led to the creation of the SEC3URE Ethos, ensuring that every healthcare professional within your facility meets credentialing and compliance standards, fostering a sense of trust in patient care. The SEC3URE Ethos promotes mutual confidence among all parties involved throughout the care continuum, allowing patients to feel secure in their doctor's capabilities, providers to rely on the integrity of the hospitals they serve, and hospitals to trust that their reimbursements are protected through the compliance of their practitioners and vendors. Ultimately, this system enhances the overall quality of healthcare delivery by reinforcing a network of accountability and trust. -
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TrackMy
TrackMy
TrackMy Verivax offers a user-friendly online portal for verifying vaccines for both employees and non-employees. Users can quickly log in to confirm essential demographic details and have their vaccination records validated in just a few minutes. This system allows organizations to efficiently oversee compliance, significantly lessening the administrative workload associated with pre-hiring and employee health management. Moreover, TrackMy Vaccines simplifies the execution of both individual and group vaccination events, enhancing the overall experience for staff. Organizations can facilitate online scheduling and electronically gather consents and signatures, making the process smoother. Most importantly, it ensures adherence to regulations through its bi-directional integrations with state immunization registries, thus removing the need for manual data entry and minimizing the risk of duplicate information. By implementing this system, organizations can foster a more organized approach to managing vaccinations while ensuring that their staff feels supported and informed throughout the process. -
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Enformion
Enformion
Founded by a team of industry pioneers and experts in data technology with over two decades experience, Enformion’s data repository comprises more than 6,000 data sources and 120 billion records available via cloud-based platform, API, and batch processing. Using state-of-the-art artificial intelligence (AI) and machine learning (ML), we provide an unparalleled and comprehensive view of people, businesses, assets, and their interrelationships. Our family of solutions empower businesses throughout the United States to make informed decisions that maximize knowledge, improve efficiencies, and better serve the needs of their clients. Our Values Partnering for Success: Our goal is to build lasting relationships with our clients and partners with a single driving force and common purpose – that their continued success is Enformion’s success. Quality You Can Trust: We offer best-in-class data, analytics, and applications that are customized to each customer’s specific workflow. Built on next-generation technology, with a focus on AI and ML, our data solutions allow businesses to make informed decisions with confidence. -
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Inovalon Eligibility Verification
Inovalon
The Eligibility Verification Standard enhances both patient access and billing procedures by allowing staff to efficiently assign and prioritize patients, payers, and tasks throughout the eligibility verification process. This advanced technology surpasses mere eligibility checks by offering a comprehensive dashboard for confirming, managing, and archiving every inquiry made. It accelerates the verification process through automated enrichment, correcting incomplete or improperly formatted transactions from payers. Additionally, staff can conduct multiple eligibility inquiries simultaneously via batch file uploads that swiftly verify Medicaid, Medicare, and commercial coverage. Team members can be easily assigned tasks, follow-up flags can be set, and eligibility documentation can be generated for future use. Managing patients across batches and resolving issues is simplified, requiring just a few clicks. Ultimately, this cloud-based, all-payer health insurance eligibility verification software saves time and enhances coverage accuracy, while empowering staff to handle benefit inquiries in the manner that suits them best, ensuring operational efficiency. With its user-friendly design and powerful capabilities, it transforms the way eligibility verification is approached in healthcare settings. -
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Surglogs
Surglogs
Surglogs is a complete suite of regulatory compliance software that provides healthcare facilities with the ability to replace pen-and-paper documentation with a simple-to-navigate digital platform. Surglogs automates regulatory compliance, the administration of logbooks and supplies, narcotics and in-services, as well as the administration of drills in healthcare facilities. Surglogs has helped save thousands of dollars in labor and storage expenses for ambulatory surgery centres and hospitals across the United States by improving clinical compliance calculations and providing administrative and clinical staff with security for future accreditation surveys. -
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Rhapsody
Rhapsody
Build the interoperability solution you need. Rhapsody is a flexible toolbox which allows your team to adapt to any modern environment. Rhapsody helps you provide the highest level service by ensuring healthcare data flows where, when and how your unique environment requires. Create flexible solutions for every connection requirement. Streamline workflows using a solution that's infinitely configurable, and specifically designed for healthcare. Create intricate integrations using a robust toolkit, which has been tested around the world. The platform has customers in 36 different countries. Create FHIR interfaces that are cutting edge with ease and simplicity using REST and FHIR specific JSON. Security is a primary concern, and is built into the entire product. This is to protect any protected health information that passes through the engine.