AI & Knowledge Graph-Powered VBC Solutions to…

technology

Vertedge’s value-based care solutions empower users without technical expertise to seamlessly tackle intricate data challenges, providing high-value and usable insights that drive improvements in performance.

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technology

How It Works

1
We ingest your standard claims data…
Working with anonymized claims data from standard formats like EDI 837, CCLF, or FHIR means we don’t need to integrate with your legacy EHR system. No PHI or EHR data is required making it fast and easy to get started.  
2
Then process that data in minutes instead of days…
Our proprietary deep learning Care Coordination Intelligence Engine (CCIE) sorts the relationships and events to generate referral KPIs by provider, service line, procedure, facility and more. Reveal leakage and keepage with a user-friendly dashboard featuring trends and scorecards for healthcare managers.
3
In order to graph provider relationships…
Map care pathways, diagnoses, referrals, procedures, and interrelated conditions to improve network utilization and drive better patient outcomes.
4
So you can explore the hidden networks of care…
Learn which providers and physicians are central in your service lines and influence your patients both in and out-of-network. Identify providers who should join your network and help your current providers identify in-network resources.
5
And map patient journeys.
Using cluster analysis, the CCIE ranks the relative complexity of each patient’s unique experience compared to similar diagnoses to understand the optimal journey, discover over and under-treatment, and find the best value providers for your patients.

How It Works

We ingest your standard claims data…
Working with anonymized claims data from standard formats like EDI 837, CCLF, or FHIR means we don’t need to integrate with your legacy EHR system. No PHI or EHR data is required making it fast and easy to get started.
Then process that data in minutes instead of days…
Our proprietary deep learning Care Coordination Intelligence Engine (CCIE) sorts the relationships and events to generate referral KPIs by provider, service line, procedure, facility and more. Reveal leakage and keepage with a user-friendly dashboard featuring trends and scorecards for healthcare managers.
In order to graph provider relationships…
Map care pathways, diagnoses, referrals, procedures, and interrelated conditions to improve network utilization and drive better patient outcomes.
So you can explore the hidden networks of care…
Learn which providers and physicians are central in your service lines and influence your patients both in and out-of-network. Identify providers who should join your network and help your current providers identify in-network resources.
And map patient journeys.
Using cluster analysis, the CCIE ranks the relative complexity of each patient’s unique experience compared to similar diagnoses to understand the optimal journey, discover over and under-treatment, and find the best value providers for your patients.
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