Veradigm Payer Solutions: Helping Payers Drive Value for Providers, Members, and More

Video  |  07 June 2023

Veradigm understands payers’ need to balance cost control with the goal of providing the highest quality of care and optimizing members’ health outcomes. Meeting this need requires an end-to-end solution that gives payers the ability to deliver the meaningful improvements their members desire.1 Ranked in the top 5 in 5 categories of Payer Technology Solutions by nationally-known healthcare market researcher Black Book, Veradigm is uniquely qualified to help you drive value for stakeholders—using our proven, independent, end-to-end payer solution.

Veradigm’s Payer Solution includes:

EDI Clearinghouse

Managing payer-provider relationships and the multistep process of claim submission are incredibly complex, potentially leading to errors, administrative burdens, and payment delays. When these involve managing multiple Electronic Data Interchange (EDI) clearinghouse relationships, it results in inefficiencies and hidden costs. Veradigm’s Exclusive EDI Gateway and EDI Direct Connection solve EDI challenges by creating a single point of contact for seamless connection with providers, regardless of their clearinghouse.

Health plan analytics

Veradigm Quality Analytics identifies gaps in Star Ratings, Quality Rating Systems, Pharmacy Quality Alliance quality measures, and more—delivering insights to drive quality outcomes cost-effectively.

Bi-directional clinical data exchange

Veradigm eChart Courier™ improves efficiency for you, your providers, and your members through high-speed clinical data exchange, helping you save time, cost, and resources by automating the medical chart retrieval process.

Risk Adjustment

Veradigm Risk Adjustment Analytics assists finance, medical management, managed care, quality management, and care management teams in risk analysis by delivering precise, advanced risk adjustment algorithms built from broad data sets for superior accuracy.

HEDIS submissions

Veradigm’s eChart Courier supports data collection for Healthcare Effectiveness Data and Information Set (HEDIS), saving time, cost, and resources by retrieving medical charts electronically, and Veradigm Quality Analytics includes an NCQA Certified HEDIS engine to help close quality gaps and improve quality scores.

Watch this brief video for more details, or contact us to learn how Veradigm can help you improve your payer-provider relationships and achieve your organization’s goals.

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