Connecting patient data to improve health outcomes, control costs, and stay ahead in a patient-centric healthcare landscape
Gain an accurate and complete view of your patients' health information using an innovative new approach to patient matching.
Healthcare organizations must have an integrated, complete view of each patient’s health information to provide the highest quality care. It is critical that they can link patient records across their databases, aggregate information across populations, and achieve interoperability with other organizations. The widespread adoption of electronic health records has made these tasks easier. But providers still have an average duplicate record rate of 10-20%, and face a matching error rate of 50-60% when exchanging patient information with each other. Current technologies like Master Patient Index (MPI) solutions are no longer up to the task because their patient matching algorithms are only as accurate as the underlying patient data, which is notoriously out-of-date, inaccurate, and incomplete. A new approach to matching and linking patient information is necessary.
Link and Deduplicate Patient Records
Verato provides an innovative, big data approach to patient matching that is not limited by the quality of the underlying patient data it uses to match. This lets you assemble every patient’s complete health record 15x better than current technologies—enabling you to provide better care and eliminate the costs and risks associated with having an incomplete view of a patient’s health history. Verato can act as a standalone matching engine and Master Patient Index (MPI), or can be used to turbocharge the matching capabilities of existing MPI implementations. Because Verato is cloud-based, it is highly cost-effective and can be implemented in days or weeks, not months or years.
Automate Your MPI's Manual Data Stewardship Tasks
Many organizations have invested millions of dollars into a Master Patient Index (MPI) solution and performed several tuning efforts to ensure its accuracy. But every organization with an MPI faces the same challenge: thousands or millions of potential matches that must be manually reviewed because their underlying data is too ambiguous for even the most sophisticated algorithms to confidently make a match. Your organization is not an exception. You are either spending thousands of man-hours to resolve these potential matches, or have millions of them accumulating in backlog.
Verato can resolve 75% of these quickly and automatically, with no manual effort required on your part. Ask us about our success with San Diego Health Connect and Healthix, two large HIEs that faced some of the toughest patient matching challenges imaginable.
Stop Performing MPI Cleanups
While Verato can provide one-time deduplication and cleanup services for MPIs, organizations that subscribe to Verato’s cost-effective and highly accurate matching services can stop performing regular MPI cleanups. Verato matches and links patient records even if they have inconsistent or incorrect identity data, enabling organizations to maintain near-perfect MPIs going forward with little or no manual effort. Organizations typically see 50-60% ROI when using Verato’s subscription services instead of performing large manual MPI cleanups.
More Easily Merge and/or Migrate EHR Systems
As healthcare organizations merge, they must merge and/or migrate their EHR systems. This typically presents an enormous patient matching challenge and forces organizations to perform massive EHR and MPI cleanups in preparation. Verato can help discover duplicates within even the largest and dirtiest EHRs and MPIs, so organizations can skip the manual effort required to clean and deduplicate their EHRs and MPIs.
Validate Patient Identities at Registration
In real-time, Verato can validate incoming patient data at registration. This enables organizations to ensure that the patient is a real person in the United States, that their identifying data is accurate and complete, and that they do not already exist in the organization’s EHR.
Improve Revenue Cycle
Verato reduces the revenue cycle for providers by validating and linking patient identities across systems. Large numbers of provider claims are turned down due to differences in the patient identity on the claim compared to the payer system, and the cost of claim reprocessing averages $25 per claim, which can quickly add up to a significant drag on profitability. Verato takes raw input claims from providers and increases the find rate in payer systems by over 40%. With patient identities validated and accurately linked to claims sent to payers, providers avoid costly delays associated with reprocessing and receive prompt payment
Eligibility and Benefits
Providers need to verify eligibility and benefits prior to care to reduce reimbursement timelines. Verato validates membership and coverage to provide correct patient information at the point of care. During an eligibility and benefits verification request, Verato compares an incoming identity to CARBON to ensure the patient identity and its attributes are correct. Verato then processes the now accurate patient identity against its partner network of healthcare information suppliers and delivers a summary record of the patient’s coverage and benefits to the provider, including group name, plan type, and copayment, deductible, and coinsurance amounts. This allows government healthcare organizations to optimize both care efficacy and revenue cycles.
Enhance Interoperability for Care Coordination, Clinical Integration, and Medical Records Exchange
Healthcare organizations want to achieve true interoperability of patient data, but are limited by inaccurate patient matching—even the most expensive, largest scale Electronic Health Record (EHR) and Master Patient Index (MPI) implementations can’t adequately resolve 50-60% of patient identities that come from another organization. This is because the same patient may be represented very differently from provider to provider—for example, with an old address, a maiden name, and a mistyped birthdate. The cloud-based Verato platform acts as an “identity translator” between organizations, enabling multiple providers to identify the same patient and exchange his health information even if they know him by a different name and address. This lets providers effectively coordinate care and integrate health data from multiple organizations.
Optimize Health Analytics
Verato provides the critical foundation for optimal healthcare analytics—a complete and accurate longitudinal patient record. Healthcare providers are using big data and analytics to better understand population health, risk stratify populations for value-based and accountable care, reduce readmissions, and respond to competitive pressures. Our innovative platform offers better patient matching and supports modern health analytics with the highest accuracy rates in the industry.
Verato enables HIEs to accurately deliver each patient's complete health information at the point of care
After years of investment, growing momentum for accountable and value-based care models, and enhanced interoperability due to the transition to Meaningful Use Stage 3, Health Information Exchanges (HIEs) are at the cusp of delivering significant value. However, HIE participants often cannot locate the all of a patient’s information they seek, causing HIE adoption to suffer. This is because the same patient may visit hundreds of disparate providers over the course of her life, and each provider may know her by a different name and address and by a default or missing birthdate or SSN. Many HIEs use state-of-the-art patient matching approaches, but even the most sophisticated algorithms are only as accurate as the underlying patient data they use to make a match. Verato offers a cloud-based, cost-effective, easily implementable patient matching solution that offers the highest matching rates in the industry even when faced with inconsistent, out-of-date, or incomplete patient data across providers.
A Powerful, Accurate MPI and Record Locator Service for Public and Private HIEs
HIEs typically use a centralized Master Patient Index (MPI) and Record Locator Service to identify a patient across participants and deliver that patient’s complete health information at the point of care. But even best-of-breed MPIs have only marginal success in finding every patient across each provider where they have received care. This is because an HIE’s MPI must match patient data from disparate providers—each of which has different standards for data governance and widely varying levels of data quality, accuracy, and completeness. Verato offers a new, cloud-based approach to patient matching that is faster to implement and more cost effective than other MPI tools—and it can accurately link patient records even if those records have inconsistent, out-of-date, or incomplete data. And, Verato can act as a Record Locator Service by securely and privately storing record location attributes for each patient in the MPI.
Turbocharge the Matching Capabilities of Your Existing MPI
Every HIE’s Master Patient Index (MPI) has thousands of duplicates that have been falsely left unmatched. On top of this, every EMPI, no matter how sophisticated and expensive, creates thousands or millions of potential matches that must be manually reviewed because their underlying patient data is too ambiguous for the EMPI to confidently make a match. HIEs are faced with either spending thousands of man-hours and potentially millions of dollars to manually resolve these potential matches, or ignoring them and leaving providers with incomplete views of their patients’ health histories. Using its innovative new approach to patient matching, Verato can find 98% of duplicates in an MPI and resolve 75% of ambiguous potential matches in a matter of days.
Verato enables payers to accurately identify members and integrate member data across their institutions
Payers and managed care organizations are driving towards a more member-centric model due to both market pressure and regulatory changes, while members are demanding more information and better service. This is causing payers to focus on getting more insight out of member data that is increasing in volume but decreasing in quality. In fact, 30% of the identity data contained within member records is old, inaccurate, mistyped, misspelled, erroneous, or incomplete—and current technologies cannot see through this bad data to identify the same individual across an insurance institution.
Reduce Manual Claim Processing Costs
Incorrect or inconsistent identity data, whether in member records or in claims, causes some claims to fall out of automated processes, leading to expensive and lengthy manual intervention. Verato can more accurately identify which member or individual is filing a claim, without manual intervention. Verato can also correct the identity data on incoming claims or member records.
Coordinate with Third Parties and Government Benefit Programs
Determining liability with other payers or third party service providers is hampered when member information is inaccurate or incomplete, because members cannot be identified and matched across institutions. This is further complicated when coordinating with government programs that still require the use of SSN, despite private payers being encouraged to discontinue using SSN as a key identifier. Verato can correct member identity data to ensure more accurate matches between institutions, or can dramatically increase match rates regardless of the quality of member identity data.
Gain a Longitudinal View of Members to Improve Care and Service
Effective member-centric programs such as wellness programs, disease management, patient pre-approval processes, and digital marketing strategies depend on having a longitudinal view of each member. This means correctly linking all the instances of a given member’s records together so the information can be aggregated and analyzed. Verato uses a revolutionary matching engine to accurately link 98% of records throughout an enterprise, allowing payers to improve their member-centric service models and improve care.
Automate Data Stewardship in MPI and MDM Solutions
Many payers use EMPI or MDM technologies to find and correct duplicate member data—but these solutions divert many potential duplicates to a queue that must be reviewed manually. Organizations either invest time and money in reviewing the potential duplicates or they ignore them entirely. Verato uses a revolutionary matching engine to automatically resolve these manual data stewardship decisions, saving payers time and money and simplifying the data governance process.
Improve Analytics for Risk Pools, Fraud Detection, and Reporting
Whether used for reviewing risk pools, identifying fraudulent patterns, or reporting for ACOs, effective analytics require correct, complete, and comprehensive member data. Analytics suffer when identity data is old or incomplete, and when member or patient records cannot be linked across different systems. Verato corrects, completes, and updates identity data, and links records across systems even if the data within those records is bad.
Determine Patient Contribution for Medicare Advantage
Payers providing Medicare Advantage solutions have a challenge in determining a patient’s contribution during their first and second year of coverage. With incomplete or nonexistent historical medical records, a new patient is assumed to be in the lowest risk pool, and therefore receives the lowest premium. Verato can enable a deeper longitudinal view of the care history for a patient, so new Medicare Advantage members can be assigned to the more accurate patient contribution pool.