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Decision Support

Vericred’s data solutions enable tech companies to build robust decision support experiences, bringing transparency and guidance to the confusing world of health insurance and employee benefits. From plan search, to provider search and physician referrals, to ICHRAs, Vericred offers a single point of integration for those seeking to deliver individual, employer, and broker-facing solutions.

APIs

Our APIs enable innovative health insurance and employee benefit decision support solutions.

Benefits API

Vericred’s Benefits API delivers health insurance plan cost share information (benefits) to power applications ranging from plan comparison experiences to displaying employee benefits on a BenAdmin platform. We apply a Bakus-Naur Form (BNF) context-free grammar to all benefit presentations for highly consistent and parsable benefit data.

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Provider Network API

As provider networks continue to narrow, and fewer and fewer health plans offer out-of-network coverage, it has never been more important to find an health plan in which your doctor(s) and facilities participate and/or to find a doctor that participates in your health plan. Vericred maintains the most comprehensive set of provider network data across all market segments, from Medicaid to self-insured rental networks, in order to power any provider network related experience.

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Card Scanning API

Developers building physician referral applications often encounter a foundational problem: most people do not know what insurance plan they have, let alone what network is attached to that plan. As a result, making in-network referrals is challenging. Vericred’s Card Scanning API extracts data from images of a health insurance card and returns the holder’s health plan network. This network can then be used for an in-network provider search and referral.

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Formulary

Drug costs represent over 20% of U.S. healthcare spending. Finding a health plan through which your preferred drugs are covered at the lowest cost share level, or finding a therapeutic alternative with better plan coverage, can move the needle on total cost of health care. Vericred’s Formulary API enables such applications and others.

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ICHRA Affordability Calculator

ICHRAs are hot! Companies considering migrating some or all of their team to ICHRAs must consider the design of their ICHRA and compliance. Our ICHRA Affordability Calculator API returns the minimum employer contribution required to meet the affordability requirements and does so across several methods.

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SBC Digitization

For developers seeking large group plan benefit data through an API, Vericred will accept large group SBCs, digitize them, apply our Bakus-Naur Form (BNF) context-free grammar, and deliver the benefits through our Benefits API. This is particularly useful for plan comparison, benefits display on BenAdmins, concierge applications, and digital health applications.

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Data Sets

We operate as a data translation layer between hundreds of carrier and tech partners by delivering normalized, structured data through modern APIs.

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Plan Design & Rate Data

Vericred serves as a connection point between health plans and health tech companies by delivering structured health insurance data through a universal API.

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Provider Network Data

Our platform partners have access to the world’s largest plan library, complete with plan design and rate, provider-network, formulary, enrollment, and member management data.

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Formulary

Data is processed through Vericred’s rigorous and proprietary methodology and is delivered normalized, structured, and cleansed with clear fields and benefits defined and ready for parsing.

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Our Solutions Enable Your Company’s Mission

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Latest Insights

From our team of experts

Arguing API vs EDI is Missing the Point

APIs are the future, but there’s a way to elevate EDI to achieve API-like, near real-time synchrony and high data quality…

Case Study: Reclaim

Reclaim’s co-founder and CEO, Nataly Youssef, shares how Vericred’s data has helped Reclaim source provider network data…

Omaha World-Herald: Vericred, an insurance tech company, will open Omaha office in Old Mill area

New York City-based Vericred has opened an Omaha office, lured by the area’s insurance industry talent and startup scene. The insurance…