Proactive, clinically-driven services to help health plans and their network providers close care gaps. Veradigm's Gap Closure Services—powered by the CORE Program (Comprehensive Outcomes Realization and Engagement)—support providers in taking gap closure to the next level by delivering services to identify, close, and document care gaps for network providers, helping health plans realize improved patient outcomes and additional revenue. Services equip providers with clinical services to proactively bridge care gaps and optimize outcomes, prioritize interventions using digital integration and quality analytics to focus on high-impact areas including annual physicals, immunizations, and preventive screenings, and deliver results that enrich patient health, improve care quality, and secure maximized reimbursements to generate measurable ROI.

Enhance epidemiology, health economics, and outcomes research (HEOR), and market access initiatives. Veradigm's RWE solutions empower life sciences organizations to transform fragmented datasets and disparate data sources into clear, actionable insights that drive better clinical, regulatory, and commercial outcomes. Veradigm RWE experts bring deep expertise in generating insights from industry-leading databases, including Veradigm's Real-World Data assets, collaborating closely with researchers to define study objectives, overcome design challenges, and deliver timely, data-driven results. Services include retrospective studies (comparative effectiveness research, treatment patterns, healthcare resource utilization, burden of disease), prospective studies (safety studies, custom clinical registries, clinical trial support), and full data integration connecting Veradigm data and custom datasets for comprehensive patient care insights.

Increase healthcare revenue cycle management (RCM) efficiency with analytics and expert support. Veradigm Revenue Cycle Services enable providers to lower AR days, reduce claim errors, and process fewer denials with measurable improvements including 99% net collections, 98% first-pass clean-claims rate, and 3–5% average revenue improvement across over 29,000 providers managing $4.2B in annual payments. Services include billing management, claims processing optimization, coding enhancement, and timely payment processing, leveraging 30+ years of experience to boost financial health and achieve measurable improvements in practice performance while allowing providers to focus on patient care.

Automate and optimize patient scheduling with artificial intelligence. Veradigm AI Patient Scheduling (Predictive Scheduler) automates and optimizes patient scheduling workflows using artificial intelligence to improve operational efficiency and patient satisfaction. The platform reduces no-shows, optimizes provider utilization, and improves patient access to care through intelligent scheduling algorithms that predict patient behavior and optimize appointment allocation.

Registry participation for providers. Veradigm Clinical Data Registries improve care and advance real-world research in collaboration with the American College of Cardiology, enabling providers to gain deep insights using comprehensive data to understand patient journeys and disease profiles, support life science research with detailed clinical information and outcomes, identify clinical trial sites suitable for clinical trials, and collect custom data tailored to meet specific research needs. The registries provide research-ready data solutions that support quality improvement initiatives and contribute to advancing clinical knowledge in specialty areas.

One cloud-based data management platform for all government programs. Veradigm Comprehensive Submissions secures the entire encounter submission process with complete visibility and control, ensuring every claim is accurately processed and compliant to reduce errors, ease administrative burdens, and expedite reimbursement. The platform provides complete visibility to manage the entire encounter submission lifecycle with a 360° view that streamlines source data reconciliation, error-free processing by validating 100% of pre-submission data according to CMS and state guidelines to minimize rejections and secure optimal reimbursement, and optimized workflow with configurable workflows and online dashboards to simplify error correction and reduce administrative burdens.

Connecting EHR Vendors with Lab and Radiology centers. Veradigm DORN is a healthcare IT solution that helps providers and EHR vendors exchange diagnostic orders and results through a single, centralized connection, replacing manual processes with automated, validated data exchange that strengthens accuracy and reliability across clinical workflows. The platform connects to more than 500 labs and radiology centers nationwide through a single API and eliminates the need for individual interfaces, receives diagnostic orders and results directly in the EHR in real time helping providers avoid delays in care, ensures order completeness and accuracy in real time, and relies on consistent performance with 99.9% network uptime across diagnostic workflows.

Boost productivity and reduce costs with Veradigm eChart Coder. Veradigm eChart Coder employs advanced technologies—such as Natural Language Processing (NLP), Machine Learning (ML), and Optical Character Recognition (OCR)—to identify, document, and code patient conditions with precision, built for coders by coders using a two-stage coding engine. The platform improves coder productivity and workflow efficiency, delivers audit-defensible results for regulatory compliance, and integrates smoothly into existing systems without taxing IT resources. The computer-assisted coding engine pre-populates charts to give staff a head start, focuses on critical dates of service, and orchestrates an intuitive, easy-flow code entry process engineered to support multiple submission types and scale effortlessly.

Automated electronic chart retrieval. eChart Courier eliminates the cumbersome manual process of chart chasing by automating medical chart retrieval and delivery, used by more than 300,000 healthcare providers to send and receive charts in a secure electronic format. The platform automates retrieval to cancel manual chart retrieval, saving time and reducing labor demands, improves data sharing by delivering patient charts securely and accurately with encrypted transmission that adheres to HIPAA standards, improves operational efficiency by freeing up staff to focus on patient care rather than administrative tasks, and increases accuracy by ensuring correct patient matching and detailed reporting for full traceability.

Automated exchange of clinical data and medical record information for analysis. eChart Integration and Analytics automates the extraction of clinical information from diverse EHR systems using HL7® FHIR® standards, turning raw, machine-readable data into human-friendly, coder-ready formats to pave the way for better quality analytics and risk adjustment. The platform provides fast, consistent connectivity to access clinical data from a network of over 200,000 providers and multiple EHR systems quickly, unified data transformation to convert XML data to easy-read PDFs and structured outputs ready to feed into quality or risk adjustment analytics, reduced turnaround time to decrease traditional chart retrieval cycles to a month or less to expedite decision-making, and more engaged collaboration by automating member matching, practice mapping, and patient subscriptions while guaranteeing data is safely encrypted.

Automate finance workflows and improve visibility into spend, reporting, and compliance. Veradigm ERP Fiscal Management automates finance workflows and improves visibility into spend, reporting, and compliance for healthcare providers. The platform streamlines financial operations, provides real-time visibility into organizational spending and financial performance, and ensures compliance with healthcare financial regulations and reporting requirements.

Track supply usage in clinical settings to reduce waste and improve accuracy. Veradigm ERP Point of Use tracks supply usage in clinical settings to reduce waste and improve accuracy through real-time visibility into supply consumption and inventory levels. The platform enables providers to optimize supply chain management, reduce unnecessary spending on medical supplies, and improve clinical workflow efficiency by ensuring supplies are available when needed.

Streamline purchasing and inventory with real-time visibility from requisition to delivery. Veradigm ERP Supply Chain streamlines purchasing and inventory management with real-time visibility from requisition to delivery for healthcare providers. The platform optimizes procurement workflows, reduces supply chain costs, and improves inventory accuracy through integrated purchasing and inventory management capabilities.

Integrate with a mobile-first patient engagement platform. FollowMyHealth unlocks the potential of practices with secure, efficient patient engagement that empowers patients with actionable communication to help improve care quality and outcomes, enhances patient satisfaction with convenient, easy-to-use, two-way communication, and reaches patients where they are by engaging patients on their mobile device. The platform facilitates secure messaging, appointment scheduling, and health information access to strengthen patient relationships and drive better health outcomes.

Go beyond Social Determinants of Health (SDoH). Veradigm Health Equity Analytics develops a broad view of member health by incorporating non-medical drivers (NMDoH) into strategy with demographic and socioeconomic data to uncover hidden disparities and design targeted interventions for meaningful population health outcomes. The platform reveals disparities by drawing on NMDoH data—such as housing, transportation, food security, education, and employment—to identify at-risk members and reveal overlooked gaps in care, applies holistic insights from non-medical factors to craft personalized care plans that address root causes of health disparities, and improves outcomes by increasing population health management, heightening member satisfaction, and meeting regulatory standards while reducing complications and long-term healthcare costs.

Simplified software for effortless scheduling, billing, and claims processing. Veradigm Practice Management advances practices with a reliable solution that maximizes operational efficiency by simplifying scheduling, collections, claims data, and more, while automating workflows to expand resource productivity. The platform enables informed decision-making through intuitive dashboards and real-time financial forecasting, helping practices manage operations more effectively and improve overall financial performance.

Proven analytic solution to help plans enhance Quality performance across their member base. Veradigm Quality Analytics converts diverse data sets into clear, actionable insights that help health plans uncover unmet care needs in medical, dental, pharmacy, and additional benefit areas with proactive alerts that identify members with open care gaps using precision patient care analytics. The platform provides efficient workflows that seamlessly integrate with existing systems to prioritize high-impact interventions, in-depth reporting with customizable reports in CSV and TXT formats for effortless visualization and analysis, and integrated decision-making leveraging real-time insights to inform timely, effective actions. NCQA Certified HEDIS® Vendor™ supporting performance across HEDIS, Quality Rating Systems, Star Ratings, and more.

SaaS application enabling efficient analysis of real-world data. The Veradigm Real-World Evidence Analytics Platform (formerly Evalytica) is a powerful self-service analytic platform that empowers researchers and analysts to conduct independent analysis of real-world healthcare data with advanced analytics capabilities. The platform provides researchers with tools to generate timely and clinically relevant insights from diverse, high-quality data sources, supporting retrospective and prospective research models tailored to research objectives with flexible study designs and regulatory compliance.

Analytics to find and prioritize gaps and opportunities. Veradigm Risk Adjustment Analytics converts complex clinical and financial datasets into clear, actionable insights with precision scoring that consolidates clinical and financial data to generate accurate risk scores capturing chronic conditions and unsubmitted diagnoses. The platform provides predictive insights through advanced algorithms, big data mining, and multiple predictive models to prioritize intervention opportunities across Managed Medicaid, ACA Commercial, and Medicare Advantage markets, with real-time oversight through dynamic dashboards to monitor gap closures, risk adjustment revenue, and performance against KPIs.

Real-time visibility to monitor and manage your KPIs for risk and quality alike. Veradigm Payer Analytics offers a unified solution that marries risk adjustment with quality management in a single workflow, creating complete transparency across risk adjustment, quality, and pharmacy programs to maximize financial performance and clinical outcomes. The platform provides end-to-end efficiency through bidirectional connection that streamlines data integration, provider engagement, and workflow management, improved performance using advanced risk adjustment analytics to boost both risk and quality scores for accurate funding and optimal care, targeted interventions to deploy the right intervention at the right time with precision to efficiently close care gaps, and a complete toolkit benefiting from a full suite of capabilities covering every facet of strategy from Health Equity, Risk Adjustment Analytics, and Risk Mitigation to Comprehensive Submissions and Emergency Department Utilization.

RADV audits - be prepared, not scared. Veradigm Risk Mitigator shields organizations from the financial fallout of data validation audits with proactive risk management that identifies high-risk conditions and providers and delivers actionable alerts to help take preemptive measures and safeguard financial health. The platform preempts audit risks by identifying and quantifying the conditions and providers putting the plan at risk, provides actionable alerts with targeted, confidence-adjusted risk estimates to back research, correction, and provider education initiatives without increasing false negatives, and guards financial health by serving as the voice of caution to manage audit risk and help plans secure their fair share while mitigating costly errors.

Delivers visibility needed to monitor and manage key performance indicators. Veradigm Utilization Analytics (Emergency Department Utilization) gains crucial visibility into emergency department trends to understand cost pressures and service inefficiencies with the ability to monitor usage patterns, reduce wasteful spending, and inform strategic network improvements that improve overall care quality. The platform assesses utilization by tracking emergency department trends to identify patterns that signal potential risks and cost pressures, reduces waste by targeting interventions to decrease unnecessary ED visits, limit revenue leakage, and increase patient care quality.

Connect the latest health tech solutions with the physicians and patients who need them. Veradigm Connect helps innovators integrate their healthcare IT applications with Veradigm systems and connect them with physicians and patients by joining the Veradigm Network, a growing ecosystem of healthcare IT providers, EHR platforms, and clinical users. With flexible subscription tiers, open APIs, and a developer portal full of resources, Veradigm Connect supports every stage of integration with open developer portal offering free access to build, test, and deploy healthcare applications using FHIR® and Unity APIs, tiered subscription plans offering scalable support, certification, and marketing opportunities, and integration testing and certification to ensure readiness for deployment with Veradigm clients.

Adaptable ambulatory EHR platform that supports clinical documentation and workflow needs. Veradigm EHR improves patient care and simplifies operations with complete patient insights for informed care, increased efficiency through improved processes and reduced administrative burdens, and boosted profitability through improved financial performance and practice growth. The platform integrates clinical, operational, financial, and wellness tools and supports transition to value-based care with tailored support for evolving healthcare models. Ranked #1 by Blackbook for family practice and primary care practices for ease of navigation, telehealth integration, and exceptional client experience.

Affordable and certified e-Prescribing solution including controlled substances. Veradigm ePrescribe automates workflows and increases the level of patient care with increased efficiency through electronic prescribing within clinical workflow, improved adherence through medication adherence, satisfaction, and efficiency, and reduced administrative burden by eliminating calls and faxes. The platform ensures comprehensive coverage with access to medication histories, formularies, and automatic interaction checks, supporting safe and confident prescribing.

Integrated, advanced, easy-to-use ePrescribing for EHR and HIT vendors. Veradigm ePrescribe Enterprise is a trusted healthcare IT solution that helps EHR vendors and HIT companies deliver secure, compliant, and easy-to-integrate ePrescribing functionality backed by two decades of experience. The platform supports regulatory compliance, optimizes prescribing workflows, and improves the patient experience with tools that promote safety, speed, and transparency. Used by over 100,000 providers monthly, the platform meets ONC and DEA standards and offers flexible API and single sign-on (SSO) integration for fast deployment and consistent user experience, includes a comprehensive medication management toolkit with access to history, formularies, and drug interaction alerts, and integrates electronic prior authorization (ePA) to automate requests and improve workflow efficiency.

Simplify patient billing and boost collections with intelligent, automated payments. Veradigm Intelligent Payments streamlines patient billing workflows and enhances collection efficiency through automated payment processing and intelligent routing. The platform improves patient satisfaction and practice cash flow by making payment processes more convenient and transparent for patients while reducing administrative burden for practice staff.

All-in-one revenue cycle management solution that features a top-tier clearinghouse and EDI gateway. Veradigm Payerpath increases profitability with award-winning RCM solutions that refine claims management to reduce rejections and denials, improve remittance processing with timely electronic EOB notifications, and ease workers' compensation management from eligibility to patient collection. The platform verifies eligibility benefits with real-time insurance information for efficient payments and unifies disparate data flows into a single, efficient gateway leveraging decades of payer expertise to simplify electronic data interchange (EDI) challenges.