Powering Care Access and Enterprise Growth with Trusted Provider Identity Intelligence

This health system manages provider data across a complex yet typical ecosystem, including Epic®, credentialing systems, employment systems, CIN applications, analytics platforms, and CRM tools. Each system of record, engagement, and insight maintains its own version of provider and location data, which results in inconsistent identifiers, incomplete attributes, and limited governance.

This fragmentation causes data quality issues and reduces visibility into relationships among employed and clinically integrated network (CIN) providers, hampers referral optimization, lowers confidence in reporting, and increases manual reconciliation across claims, analytics, and engagement workflows.

Inconsistent provider data hindered their enterprise initiative to improve patient access, engagement, and care pathways, which rely on accurate provider directories, trusted specialty data, and clear network relationships. Without enhancements in the quality and availability of provider data, scalable analytics to support growth and achieve the desired outcomes are limited.

This health system selected Verato Provider Data Management™ as its enterprise master data management (MDM) platform for providers and locations, tailored specifically for healthcare and offering capabilities far beyond traditional, legacy MDM. Verato Provider Data Management (PDM) consolidates fragmented provider identities, delivers industry-leading accuracy in identity resolution, enriches provider attributes with trusted data, and provides tools to manage provider identities to prevent downstream errors.

Within Verato, provider and location records are reconciled using healthcare-specific referential matching and enriched with critical attributes such as NPIs, licenses, taxonomy codes and validated, timely address data. Provider profiles are
standardized across specialties to improve clarity and analytics, creating a unified view that supports better decision-making, including customer-focused care navigation. A stewardship interface enables centralized ongoing governance and accountability, allowing the health system to identify the root causes of provider data issues and correct them upstream, rather than repeatedly fixing errors downstream in operational systems that continue to pollute the ecosystem.

From this unified foundation, Verato delivers purpose-built views of provider data to downstream systems, including Epic®, analytic tools, CRMs, and claims-related workflows. Each system receives trusted provider data tailored to its specific needs, enhancing performance without disrupting existing applications.

Early in the partnership, Verato analyzed the value of Verato Provider Data Management to confirm the platform’s capacity to resolve fragmented identities and generate actionable insights.

The analysis also revealed significant overlap among employed, credentialed, and clinically integrated network providers, providing new insights into network composition and referral trends. These findings highlighted that provider identity is not merely a data quality issue but also a strategic asset for growth, analytics, and financial success.

With Verato Provider Data Management™, the health system is transforming provider identity from a siloed, reactive function into a strategic enterprise capability—creating a scalable foundation for growth, revenue protection, and operational excellence.