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Provider Network Data

It has never been more important to find a plan in which your doctor participates and to find doctors and facilities that participate in your plan. Vericred’s provider network data speaks to which doctors and facilities, and other practitioners, are in each provider network.

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Provider Networks

Comprehensive network coverage across carriers, states, and market segments

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Employer Group Networks

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Individual Under 65 Networks

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Medicare Advantage Networks

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Medicaid Networks

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Dental Networks

Use Cases

Our comprehensive provider network data powers mission critical functionality.

Shop-by-doc

From state-based ACA exchanges to WBEs to broker quoting solutions, Vericred’s provider network data is a comprehensive solution to powering provider-centric health plan search or “shop-by-doc.”

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Disruption Analysis

Disruption analysis doesn’t have to be expensive, time consuming, nor reserved only for large groups. Vericred’s provider network data powers dynamic group disruption analysis. ICHRA solutions can power group-to-individual disruption analysis.

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PCP Selection

Vericred’s provider network data enables enrollment and BenAdmin solutions to build PCP selection into their enrollment flow instead of requiring the individual to go out to the carrier’s website.

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Provider Directories

Vericred’s provider network data is a key component to provider search and display.

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Physician Referral

Follow-through markedly increases when a patient is referred to a physician who is in their network. Vericred’s provider network data enables this critical functionality.

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Doctor Appointment Apps

Vericred’s provider network data enables appointment applications to add network search functionality for better consumer experience.

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The Details

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Key Elements

  • Substantially all carriers and networks
  • Networks and specialties maintained at the address level
  • Normalization of names, specialities, and addresses (geocoded)
  • Solution for “multiple NPI” problem
  • Provider mapping at the network, HIOS ID, and Contract ID
  • Network tiers
  • 30 day refresh cycle
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File Formats

  • jsonl
Vericred has industry-leading provider network data that is core to our product’s success.
Oron AfekVim CEO

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