JSON twin: https://www.healthaidb.com/software/medversant.json
Medversant
https://www.medversant.com/our-technologies.html
Medversant provides ProviderIQ™, a provider data management platform and services for credentialing, provider directories, network enrollment, network adequacy, claims screening, and continuous monitoring aimed at health plans, payers and provider organizations.
Medversant is a commercial provider data management vendor offering a suite (ProviderIQ™) of web-based applications and outreach services that centralize and automate provider credentialing, enrollment, directory management, network adequacy, virtual peer review, non-responder outreach, and claims screening with primary-source verification and continuous monitoring.
unknown
1999
P1054
2025-09-07
commercial / proprietary
Contact vendor for pricing, demo and implementation details.
enterprise_quote
product
1.0
{
"company_name": "Medversant",
"company_url": "https://medversant.com/",
"company_offices": [
"United States"
],
"company_founding": "1999",
"product_url": "https://www.medversant.com/our-technologies.html",
"categories": [
"administrative",
"provider data management",
"credentialing",
"provider directory",
"compliance"
],
"market_segment": [
"enterprise",
"health plans",
"public sector"
],
"links": [
"https://medversant.com/",
"https://www.medversant.com/our-technologies.html",
"https://www.medversant.com/provideriq/MedversantCredentialingCVO.html",
"https://www.medversant.com/providers.html",
"https://www.medversant.com/about-us.html",
"https://www.medversant.com/contact-us.html",
"https://www.providersource.com/Account/Login.aspx",
"https://reportcard.ncqa.org/cvo/CVODetail.asp?OrgID=2966",
"https://www.linkedin.com/company/medversant-technologies-llc",
"https://www.crunchbase.com/organization/medversant"
],
"summary": "Medversant provides ProviderIQ™, a provider data management platform and services for credentialing, provider directories, network enrollment, network adequacy, claims screening, and continuous monitoring aimed at health plans, payers and provider organizations.",
"description": "Medversant is a commercial provider data management vendor offering a suite (ProviderIQ™) of web-based applications and outreach services that centralize and automate provider credentialing, enrollment, directory management, network adequacy, virtual peer review, non-responder outreach, and claims screening with primary-source verification and continuous monitoring.",
"target_users": [
"health plan administrators",
"payers",
"credentialing specialists",
"provider enrollment staff",
"network managers",
"claims integrity teams",
"provider organizations"
],
"specialties": [
"primary care",
"behavioral health / psychiatry",
"pediatrics",
"internal medicine",
"cardiology",
"surgery",
"radiology",
"OB/GYN",
"dermatology",
"pharmacy"
],
"regions_available": [
"United States"
],
"languages_supported": [
"English"
],
"pricing_model": "enterprise_quote",
"pricing_details": "Contact vendor for pricing, demo and implementation details.",
"license": "commercial / proprietary",
"features": [
"Network enrollment workflow with contract upload and digital signature",
"Primary-source credentialing with patented automated verification",
"Provider directory management with real-time updates",
"Virtual Review Committee (web-based peer review, voting, reporting)",
"Network adequacy analysis (geocoding/mapping, distance/time rules)",
"Non-responder outreach and tracking with time-stamped attempts",
"Claims screening (ClaimGard) to validate provider eligibility on claims",
"Continuous monitoring of sanctions and disciplinary databases",
"CAQH and internal database pre-population",
"Approval workflows and provider pre-screening",
"Audit trails and date-stamped verification images",
"Reporting and dynamic analytics",
"Provider self-service/co-branded update interface",
"Provider matching to products/plans"
],
"integrations": [
"CAQH",
"Internal health plan databases",
"Claims processing/fraud detection systems (integrates with existing fraud systems)"
],
"deployment_model": [
"SaaS",
"web-hosted"
],
"os_platforms": [
"Web"
],
"optional_modules": [
"Virtual Review Committee (VRC) module",
"Network Adequacy module",
"Claims Screening (ClaimGard) module",
"Non-Responder management module"
],
"data_standards": [
"CAQH (connectivity/pre-population)",
"CFR provider directory regulations (422.111, 422.112) compliance"
],
"api_available": "unknown",
"system_requirements": "",
"compliance": [
"HIPAA (implied by PHI handling and industry practice)",
"Federal and state provider directory regulations (CFR references)",
"State-specific MCO/network adequacy requirements"
],
"certifications": [
"NCQA (displayed on site)",
"USFCR Verified Vendor"
],
"security_features": [
"Role-based access / multiple user permission levels",
"Audit logs and time-stamped records",
"Digital signature support",
"Secure web-based access"
],
"privacy_features": [
"Continuous monitoring of sanction databases",
"Time-stamped outreach records for audit/compliance"
],
"data_residency": "",
"customers": [],
"user_reviews": [],
"ratings": [],
"support_channels": [
"phone"
],
"training_options": [],
"release_year": "",
"integration_partners": [
"CAQH",
"Unisys",
"NCQA",
"USFCR"
],
"id": "P1054",
"slug": "medversant",
"type": "product",
"version": "1.0",
"last_updated": "2025-09-07",
"links_json": {
"self": "https://www.healthaidb.com/software/medversant.json"
}
}