What You Should Know:
– Certify, a provider data intelligence company, has announced the launch of Provider Hub, its comprehensive Provider Data Management (PDM) solution.
– The platform is the only end-to-end solution offering a unified, real-time, 360-degree view of every provider in a healthcare organization’s network.
AI-Powered, Transparent, and Flexible Foundation
Inaccurate provider data creates significant friction across nearly every function of a health plan, leading to delayed payments, poor member experience, and increased compliance risk under mandates like the No Surprises Act and the Transparency in Coverage Rule. Provider Hub aims to solve this by fundamentally replacing siloed systems, spreadsheets, and outdated data management tools.
Certify’s solution is designed to act as a continuously updated source of truth, enabling organizations to improve data accuracy and reliably scale automation and AI. The platform addresses the fact that 85% of AI projects fail, often due to poor data quality, by providing a trusted foundation.
Provider Hub unifies, cleanses, normalizes, and validates data from a wide range of sources, including credentialing, directories, claims, rosters, and internal systems. This reduces manual effort and delivers operational insights across the enterprise.
Key capabilities of the AI-driven solution include:
- Data Unification and Cleaning: Ingests data from structured and unstructured sources and validates it using thousands of rules and over 1,600 primary sources.
- Duplicate Resolution: Uses AI-driven logic to resolve duplicates and link records across systems, maintaining data integrity.
- Complex Modeling: Models complex relationships between providers, groups, locations, and plans, with full audit trails.
- Real-Time Workflows: Runs credentialing, monitoring, and outreach workflows in real time to reduce turnaround and touchpoints.
Fixing the Root Issue for Enterprise-Wide Performance
Anshul Rathi, founder and CEO of Certify, emphasized that the platform doesn’t digitize old workflows; it replaces them. He stressed that what makes Provider Hub different is its ability to serve as a single foundation across all departments.
When provider data is reliable, everything downstream runs better. The transformation enabled by Provider Hub leads to better performance across claims, compliance, directories, and provider experience by fixing the root issue of fragmented data, rather than patching existing systems. The company has already secured multiple signed deals with customers seeking to address persistent pain points like credentialing delays, data duplication, and compliance risk.
