Top symplr Payer Alternatives

Incredable serves as a comprehensive and customizable credentialing platform that connects healthcare facilities, providers, and administrators effectively. The solution simplifies the credentialing workflow by managing documents, tracking compliance, and verifying credentials seamlessly. By using Incredable, healthcare professionals can maintain their compliance and readiness consistently. Widely recognized in the healthcare sector, Incredable alleviates the strain of administrative tasks, boosts operational productivity, and promotes smooth collaboration among all parties involved, enabling healthcare teams to concentrate on providing exceptional patient care. Furthermore, this innovative solution adapts to various healthcare needs, making it an invaluable tool in today’s dynamic environment.

CredentialStream® utilizes innovative patented technology to facilitate the requesting, collection, and verification of provider information, ultimately creating a trustworthy Source of Truth for subsequent processes. Its cutting-edge platform is regularly enhanced and is supported by extensive content libraries and top-tier data sets, making CredentialStream the premier solution for managing the entire lifecycle of providers. Additionally, the seamless integration of these resources ensures that organizations can maintain compliance and efficiency in their operations.

CredentialingSpectrum is a secure, cloud-based software designed for managing medical credentials, facility operations, payer interactions, and contract oversight. This innovative healthcare credentialing system streamlines the credentialing process, enhancing overall efficiency for users. With its one-click comprehensive automation feature, CredentialingSpectrum stands out as a user-friendly solution, positioning itself as the premier provider credentialing software in the United States. Its robust capabilities enable healthcare organizations to focus more on patient care while minimizing the complexities of credentialing management.

symplr’s provider credentialing software is a holistic solution designed to manage provider information, effectively minimizing turnaround times and optimizing revenue cycles, while prioritizing patient safety at all times. This innovative software simplifies data collection, ensures secure access, enhances reporting capabilities, and maintains continuous compliance, making it easier for credentialing teams, providers, and internal approval committees to fulfill their duties. Users have reported an impressive 20% reduction in the duration needed to finalize credentialing processes, coupled with a notable 50% decrease in the frequency of committee review meetings. By leveraging this automated and user-friendly platform, organizations can efficiently gather, validate, store, and distribute essential provider lifecycle data and documents from a single, centralized hub, resulting in both significant time savings and lowered costs. Furthermore, the software incorporates a payer enrollment module, streamlining the enrollment process for providers with payers, which allows for seamless tracking of applications during the reimbursement journey. With its sophisticated automation features, the platform collects data from a variety of primary sources and performs automatic checks for expired or suspended licenses, while also cross-verifying with databases like NPDB, DEA, and SAM, thus significantly boosting the reliability and efficiency of the credentialing process. In essence, symplr’s software revolutionizes the way healthcare organizations approach provider credentialing, establishing itself as an indispensable asset within the industry. The adaptability and comprehensive nature of this solution ensure that it meets the evolving needs of healthcare providers and their administrative teams alike.

Modio Health OneView was created by professionals in credentialing and practicing physicians. This platform facilitates a streamlined and centralized approach to managing the credentials of your entire healthcare provider team. OneView efficiently gathers essential information about providers, including their NPI, DEA, and license numbers. By ensuring compliance, OneView allows your providers to concentrate on delivering quality clinical care without distraction. This innovative tool enhances the overall efficiency of healthcare operations, making it an invaluable asset for any medical organization.

For three decades, Verisys has been a reliable collaborator for some of the most complex healthcare organizations across the United States, overseeing the credentialing process for more than two million occurrences annually. Our credentialing solutions are designed to help you achieve compliance seamlessly. The tasks of credentialing and re-credentialing healthcare providers present significant challenges for hospitals, health plans, and health systems. Given that many physicians hold licenses in various states and provide telehealth services across state borders, it is crucial to verify their licenses with each state board and adhere to the unique regulations applicable in those regions. Furthermore, identity verification can be quite complicated, as numerous physicians may have similar names, including maiden names, aliases, and shortened versions. To gain a thorough understanding, it is vital to conduct an extensive screening of each physician and validate their credentials against a wide range of primary sources. Our proficiency ranges from performing basic provider credential searches to implementing comprehensive credentialing systems that optimize the entire process. With our assistance, you can navigate the complexities of credentialing more easily, allowing you to concentrate on delivering exceptional care to your patients. Ultimately, our commitment to excellence ensures your organization remains compliant and capable of addressing the evolving needs of healthcare delivery.

Medallion stands out as the premier solution designed for healthcare organizations to completely streamline their clinician operations, encompassing state license management, payor enrollment, credentialing, and additional functions within a single, contemporary management platform. Since its launch in 2020, Medallion has successfully conserved more than 100,000 hours of administrative work for top-tier healthcare providers such as Cerebral, Ginger, MedExpress, and Oak Street Health, among many others. This innovative approach not only boosts efficiency but also allows healthcare professionals to focus more on patient care rather than administrative burdens.

Certify presents a modern, API-driven solution for credentialing, licensing, and enrollment specifically designed for payors, healthcare systems, and emerging digital health companies. We deliver crucial insights that significantly improve the efficiency of clinicians, teams, and healthcare organizations. Our intuitive one-click credentialing feature allows for the effortless creation of high-quality provider networks. The real-time, automated credentialing process we offer complies with NCQA standards, facilitating the growth of provider networks. We maintain ongoing compliance through our automated monitoring systems, ensuring your provider networks remain up-to-date. By removing the complexities and administrative tasks associated with licensing, we empower you to effortlessly tap into new markets. Becoming part of our network accelerates your reimbursement processes, enabling you to dedicate more time to patient care. Our efficient system supports cross-state licensure for all types of licenses across the United States, while also simplifying the enrollment process for providers looking to expand into unfamiliar territories. You can conveniently track your enrollment status with our customized dashboards, and leverage our advanced techniques to effectively refine, standardize, and improve your provider data. This all-encompassing service not only guarantees compliance but also encourages growth in an increasingly competitive healthcare environment. Ultimately, with Certify, you can navigate the complexities of healthcare credentialing and licensing with confidence and ease.

CORE brings together diverse sectors within the industry to accelerate automation and improve business processes, making healthcare more accessible for patients, providers, and health plans. By utilizing the most trustworthy source of provider and member information, CAQH enables healthcare organizations to reduce costs, improve payment accuracy, and transform their operational frameworks. In the fast-evolving landscape of healthcare, continuous improvements in payment and claims processing remain essential. Across the nation, healthcare providers and health plans depend on CAQH to collect and manage professional data, confirm primary sources, and monitor sanctions effectively. This approach results in streamlined administration, enhanced regulatory compliance, and better oversight of provider information. Moreover, the partnership stimulates innovation, resulting in a more efficient healthcare system that benefits all stakeholders involved. As a result, stakeholders can expect to see a significant transformation in how healthcare services are delivered and managed.

Accelerate payment procedures while reducing administrative burdens. With a network of over 8,000 payer connections and partnerships with more than 650 practice management providers, our claims management solutions significantly decrease the number of pending claims and lessen the reliance on manual processes. Claims for a wide range of services, such as professional, institutional, dental, and workers' compensation, can be sent efficiently and accurately, ensuring timely reimbursements. Address the changing landscape of healthcare consumerism by providing a seamless and transparent financial experience for patients. Our tools for patient engagement help facilitate informed conversations about eligibility and financial responsibilities, while also minimizing barriers that could negatively impact patient outcomes, ultimately enhancing the overall healthcare experience. By improving transparency and communication, we contribute to a more patient-centered approach in the healthcare industry.

SKYGEN's Provider Data Management (PDM) offers a dynamic solution aimed at improving the oversight of provider networks while strengthening the ties between healthcare payers and providers. This innovative platform not only enhances the ability of payers to develop robust provider networks but also increases satisfaction for both providers and members, all while minimizing administrative costs. By incorporating advanced technology, PDM meets the expectations of modern, tech-savvy healthcare participants. It simplifies the costs associated with contract acquisition by promoting a rapid, efficient, and paperless approach to provider recruitment and supplemental network rentals. Furthermore, the system reduces credentialing expenses and boosts provider satisfaction through its streamlined online credentialing processes. By automating the self-verification of providers, it eliminates the need for expensive outreach efforts and guarantees that provider data is both accurate and verified for online directories. Ultimately, SKYGEN facilitates seamless dental and vision connectivity solutions, empowering clients to confidently navigate the future by utilizing technology that drives unparalleled efficiency and effectiveness in their operations. This forward-thinking innovation strategically positions healthcare organizations to excel in a continuously changing landscape while adapting to emerging challenges.

Successful teamwork in patient care relies heavily on ongoing connectivity and access to current information. It is becoming ever more important to facilitate the flow of this information with insurance companies. Availity streamlines the collaboration with payers, assisting providers from the initial step of confirming a patient's eligibility all the way to resolving reimbursements. Healthcare professionals seek quick and easy access to details regarding health plans. With Availity Essentials, a free service supported by health plans, providers can take advantage of real-time data exchanges with many of the payers they regularly interact with. Moreover, Availity offers a premium service called Availity Essentials Pro that is designed to enhance revenue cycle performance, reduce claim denials, and secure patient payments more efficiently. By utilizing Availity as your reliable source for payer information, you can concentrate your efforts on providing high-quality patient care. Their electronic data interchange (EDI) clearinghouse and API solutions allow providers to seamlessly incorporate HIPAA transactions and other vital functions into their practice management systems, leading to improved operational efficiency. This holistic method not only supports healthcare providers in their operational tasks but also reinforces their ultimate goal of prioritizing patient well-being and satisfaction.

Model N provides an all-encompassing platform designed to help organizations boost their revenue while updating their workflows in Sales, Marketing, Channels, Finance, and Legal. By leveraging Model N’s revenue management capabilities, companies can shift from fragmented, tactical practices to unified, comprehensive revenue processes driven by automation and insightful analytics. The Revenue Cloud seamlessly integrates front-office and back-office operations, establishing a unified system of record for all revenue-related tasks. This innovative platform allows clients to easily configure and quote complex products, quickly execute intricate contracts, and access precise, real-time data on channels, thereby enhancing transparency and understanding within their networks. Moreover, it simplifies the administration of incentive programs, which effectively helps in avoiding overpayments. Additionally, Model N’s Rebate Management feature boosts channel engagement, ultimately leading to better revenue optimization. By adopting this integrated approach, organizations can significantly improve their efficiency and effectiveness in generating revenue, paving the way for sustainable growth and success. Overall, Model N stands out as a transformative solution in the realm of revenue management.

HealthStream offers support for the EchoOneApp, which is considered a legacy system. For new clients, however, CredentialStream is the preferred option for optimal performance and modern features.

Our platform cultivates uniformity, ongoing improvement, and scalability across our interconnected portfolio, enabling customers to optimize operational efficiency, make data-driven choices, and enhance patient outcomes while fostering innovation within the dynamic healthcare landscape. By utilizing cutting-edge data analytics and integrating patient engagement and collaboration tools, the Change Healthcare platform empowers both providers and payers to refine workflows, access essential information exactly when it's required, and guarantee the provision of the safest and most appropriate clinical care available. We ensure smooth access to data and advocate for interoperability among various data sources, which aligns with CMS regulations on patient access and interoperability, ultimately facilitating real-time access to clinical documents. This method plays a crucial role in effectively managing risk adjustment, improving HEDIS scores, and guaranteeing timely and accurate payments through expedited adjudication processes. Additionally, our dedication to innovation enables us to swiftly adapt to the evolving healthcare environment while consistently enhancing the quality of services we provide. As we continue to advance our platform, we remain focused on delivering exceptional value to our customers and the patients they serve.

HealthEC provides an advanced population health management platform that includes the CareConnect™ care management module and the 3D Analytics™ module, designed to enhance care quality and improve patient experiences by addressing key data challenges in the healthcare sector. Through a universal data warehouse, it seamlessly combines normalized claims, clinical, and social determinants of health (SDoH) data from multiple sources, guaranteeing CMS certification for reuse. The platform is equipped to reduce disruptions in workflow with its customizable care plans and decision-support tools, facilitating thorough care management assistance. By encouraging patient-centered care, it promotes effective collaboration with community resources while also addressing SDoH factors. Clear dashboards and point-of-care access enable healthcare professionals to gain actionable insights at various levels, including diagnosis, provider, practice, and organization. Furthermore, it strengthens managed care organization (MCO) performance evaluations and ensures adherence to CMS interoperability regulations, thereby aiding healthcare providers in achieving better outcomes. This combination of features results in a revolutionary strategy for managing population health, ultimately leading to more efficient and effective healthcare delivery. As a result, HealthEC not only improves individual patient care but also enhances the overall healthcare ecosystem.

symplr Directory is a comprehensive provider data management platform built to help healthcare systems and organizations operate more efficiently by centralizing provider data in one location. By consolidating accurate and up-to-date information, symplr Directory ensures that healthcare providers and staff can access reliable data, eliminating duplication and reducing errors across different departments and systems. The platform facilitates the digital transformation of healthcare operations by enabling patient-friendly provider search options and allowing for easy appointment scheduling directly through the provider directory. Integration with EHRs accelerates the onboarding process and improves revenue cycles by reducing billing delays. With features such as automated provider outreach, clinical taxonomy for better patient-provider matching, and comprehensive reporting tools, symplr Directory empowers healthcare systems to improve service quality and deliver a better experience for patients. Moreover, the platform's flexibility allows healthcare organizations to reduce call center volume, automate communications, and expand their reach through a robust, scalable digital front door.

In many hospitals and healthcare practices, the process of onboarding providers is often lengthy and complicated. Furthermore, re-credentialing can feel like a fresh start, creating frustration for providers, administrative staff, and healthcare executives, who are increasingly aware that inadequate management of provider data can negatively impact both the quality of patient care and the organization’s financial stability. Unfortunately, provider management solutions, whether developed externally or internally, have experienced little advancement in the last twenty years. A majority of healthcare organizations continue to depend on scattered, labor-intensive paper methods and informal practices for collecting, managing, and processing provider information. Fortunately, I-Enroll presents a groundbreaking solution for organizations of any size, enabling them to streamline disorganized provider management tasks into cohesive, integrated systems. By adopting I-Enroll, various departments and users can collaborate effectively, operating together as a finely tuned unit. This innovative approach not only boosts operational efficiency but also significantly contributes to better patient outcomes, ensuring that healthcare providers can focus more on delivering quality care.

Transform your daily operations by regaining valuable time and cutting costs with our cutting-edge automated solutions. Effortlessly engage with key stakeholders—including providers, payers, and partners—while obtaining access to real-time, accurate data that guarantees smooth care delivery. We simplify the complex network of countless payer connections, allowing for quick and easy enrollment processes. Discover the unmatched potential of cloud technology in a whole new light. With our integrated command system, you can manage, store, and share provider information in real-time, ensuring seamless connectivity whenever needed. The provider verification process has never been easier; just submit a request, and our platform will accelerate the process for you, significantly boosting your operational efficiency. Experience a new level of workflow optimization as we guide you through streamlining your processes like never before. Embrace the future of operational excellence with our innovative solutions tailored to your needs.

EddyCore is an innovative cloud-based software solution that empowers healthcare organizations and providers by streamlining the processes of credentialing, privileging, and enrollment, thereby saving valuable time and resources. Our state-of-the-art platform integrates effortlessly with EddyOne, allowing for the smooth collection of provider information. With an unparalleled speed of implementation, we ensure that transitioning to our software is both simple and effective for users. The system allows for the delegation of verification and enrollment tasks while providing real-time tracking to ensure that no aspect of the process is overlooked. Free from the constraints of modules and feature limits, EddyCore grants users immediate access to its full range of capabilities upon sign-up. Moreover, you can generate an unlimited number of non-provider accounts at no additional cost and execute multiple primary source verifications with ease. Designed by specialists in credentialing and enrollment, EddyCore simplifies the burdens faced by those responsible for managing provider credentials, making it an indispensable resource for healthcare practitioners. Ultimately, our goal is to improve efficiency and simplify the credentialing journey, allowing providers to dedicate more time to quality patient care while enhancing the overall healthcare experience. With EddyCore, the future of credentialing is not just efficient; it is also user-friendly and adaptable to the needs of the healthcare landscape.

Experience a robust credentialing platform tailored to keep your facility healthy and compliant seamlessly. This system streamlines labor-intensive processes like primary source verification and OIG monitoring, significantly minimizing the chances of errors and missed documentation ahead of inspections. You can finally release yourself from the burden of sifting through countless paper files, as all credentials are securely stored in the cloud for easy access whenever you need it. With automatic reminders for missing or outdated credential documents, you can ensure that compliance is always a priority. Enjoy the convenience of one-click verifications for medical licenses and certifications, and simplify the online reference requests with customized questions for your needs. Moreover, you can effortlessly implement ongoing OIG monitoring and maintain NPDB Query logs, which enhances your oversight capabilities. By transitioning all credentialing tasks online, you can not only eliminate paper clutter but also effectively track appointments and reappointments while managing detailed profiles that include essential contact information and summaries. This innovative solution elevates efficiency and cultivates a more structured approach to managing credentials, ultimately leading to a more streamlined operation within your facility. With such a comprehensive tool at your disposal, navigating the complexities of credentialing becomes a more manageable and efficient endeavor.

Ringo's VMS technology stands out as a leader in the industry, designed to boost productivity and enhance engagement effectively. This comprehensive platform simplifies the processes of sourcing talent, automating timekeeping, minimizing risks, and providing real-time data visibility. With features like real-time dashboards and streamlined workflows, users can easily track candidate statuses and credentialing processes. It offers a seamless solution for sourcing talent, logging hours, and overseeing payments, all accessible via both web and mobile platforms. This ensures that your team remains adept at managing staffing needs. Developed specifically by staffing professionals for their peers, Ringo's VMS technology enhances internal transparency and boosts profitability while strengthening external partnerships. Additionally, it facilitates the engagement of locum and temporary healthcare workers with greater ease. By automating timekeeping and credentialing processes, Ringo's VMS technology empowers healthcare providers to reduce costs and mitigate risks, allowing them to concentrate on their foremost priority: delivering exceptional patient care without distractions. The platform ultimately transforms the way healthcare staffing is managed, making it more efficient and effective for all involved.

Create, distribute, and oversee credentials at your convenience with Entrust Instant ID. This innovative solution allows you to generate, distribute, and manage secure identification and credentials efficiently. It equips organizations to satisfy various application needs, spanning from simple photo identification to advanced high-security credentials. Additionally, the platform is designed to effortlessly expand from a singular workstation or user to a comprehensive enterprise solution with enhanced capabilities. This scalability ensures that as your organization grows, your credential management system can evolve seamlessly to meet increasing demands.

Develop the interoperability solution tailored to your needs with Rhapsody, a versatile toolbox that empowers your team to seamlessly adapt to any contemporary healthcare environment. By leveraging Rhapsody, you can ensure that healthcare data is transmitted precisely where and when it is needed, tailored to your unique operational requirements, thereby enhancing the quality of service you provide. Craft adaptable solutions to meet every connection necessity, and optimize workflows through a solution designed specifically for the complexities of healthcare. Utilize a powerful toolkit to create intricate integrations, backed by global testing and proven effectiveness in 36 countries worldwide. Effortlessly design state-of-the-art FHIR interfaces using REST and FHIR-specific JSON, ensuring modern compliance and functionality. Recognizing the importance of security, Rhapsody incorporates robust measures to safeguard any protected health information that traverses the system, ensuring the privacy and integrity of sensitive data throughout its lifecycle. This commitment to security not only meets regulatory standards but also fosters trust with your clients and stakeholders.

Healthcare systems can effectively align patients with the appropriate providers, enhance accessibility for patients, and handle data through top-tier solutions. Our innovative provider search and scheduling tools, which are powered by the Kyruus data management platform, empower health systems to improve the matching process for patients and providers, increase patient acquisition and conversion rates, and ensure a consistently excellent patient experience at critical entry points. Establish a distinctive digital presence that offers a contemporary access experience for patients, enabling them to effortlessly discover optimal care options and schedule appointments online. By providing your agents with the essential technology, you can facilitate connections between consumers and the best-suited providers via your call center. Furthermore, both providers and staff will have visibility into the available providers within your network, ensuring that patients leave their appointments with the reassurance that their next visit is already secured. This comprehensive approach not only streamlines patient interactions but also enhances overall satisfaction with the healthcare journey.

SKILLS Global stands out as a premier provider of web and mobile applications tailored for Applied Behavior Analysis (ABA), benefiting professionals, educators, and parents engaged with individuals diagnosed with ASD. Their comprehensive software suite serves as a centralized platform for developing personalized, evidence-based treatment plans. Additionally, it encompasses features such as data collection, scheduling, billing, contracting, and credentialing, ensuring a seamless user experience. To top it off, users enjoy the advantage of continuous, complimentary support, enhancing overall satisfaction and effectiveness.

Door Space® simplifies your financial management and automates the credentialing process, accelerating the onboarding of new hires while reducing claim denials resulting from expired or incomplete credentials. By effectively connecting isolated data within healthcare organizations, it fosters network advantages that decrease expenses, improve predictive analytics, and enhance employee retention rates. With Door Space®, all credential information is conveniently stored in one platform for easy access! It makes monitoring expiring documents and continuing education requirements straightforward, allowing you to upload new credentials with the same ease as making mobile deposits. Automated reminders help ensure you never miss a renewal date again. Furthermore, you can link your calendar to track upcoming renewals and CE courses, receive timely SMS notifications on your mobile device, and provide access to employers and authorized agents, significantly streamlining the credential management process. This all-encompassing strategy not only conserves time but also elevates the overall operational efficiency of your organization while enhancing compliance with industry standards.

HealthStream continues to provide support for MSOW, acknowledging it as a legacy system. For new clients, however, the recommended choice is CredentialStream, which offers updated features and enhanced capabilities.

MD-Staff provides a cutting-edge, cloud-based credentialing software solution enhanced by AI, drawing on over thirty years of technological advancement. Serving a diverse global audience of more than 2,000 clients, this software simplifies the credentialing workflow, oversees clinical privileges, and bolsters patient safety through automation. Users benefit from dedicated customer service tailored to their unique requirements, ensuring a supportive experience. At the core of MD-Staff is the Aiva™ Credentialing engine, which harnesses sophisticated AI and automation to drastically cut down application processing times and flag any problematic practitioner files. Furthermore, it streamlines primary source verifications through the use of web crawlers, Pronto reference checks, and strong integrations with essential primary sources such as NPDB, OIG, and SAM. The platform includes a user-friendly privileging module with a drag-and-drop interface that simplifies the creation and management of both standard and specialized privilege delineation forms. In summary, MD-Staff emerges as an essential resource for healthcare organizations aiming to enhance their credentialing and privileging procedures, ultimately leading to improved operational efficiency and patient care. This innovative approach not only saves time but also ensures a higher level of accuracy in the credentialing process.

STATCred provides clients engaged in credentialing with access to their data, allowing them to review status reports, submit necessary information, create exports, and communicate with their Medical Staff Coordinator. For healthcare organizations that have their own credentialing teams, STATCred is flexible enough to cater to their specific needs, significantly improving the efficiency and effectiveness of the credentialing process. This level of customization is vital for delivering on STATCred's service promise, ensuring streamlined workflows that align with client goals. By removing reliance on paper, users can upload and access documents online at their convenience. Furthermore, the platform features various standard management reports, the ability to craft and save custom reports, and sophisticated search options that enable users to export data queries in PDF or Excel formats for in-depth analysis. In summary, STATCred not only simplifies the credentialing process but also equips users with powerful tools for effective data management and comprehensive reporting, contributing to overall operational excellence. Ultimately, this combination of features makes STATCred an invaluable resource for organizations aiming to enhance their credentialing practices.