Convergent

Provider Data Management. Simplified.

Convergent is the AI-powered operating system for health plans without massive IT budgets.

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A Modular Ecosystem for Roster Ingestion, Provider Directories, and the Entire Provider Data Lifecycle

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Why Convergent?

Purpose-Built for Simplicity

Convergent is an AI-powered, provider data operating system that automates rosters, syncs your directories, and integrates with downstream systems without adding complexity or cost.

Built-In Compliance
Results:
73%
Time saved per employee per quarter
Real-Time Data Integrity Across All Systems

Convergent continuously standardizes, deduplicates, and enriches provider data across systems to maintain a single, reliable source of truth. Real-time updates flow downstream so you’re always working with current, clean data. Eliminate lags and silos.

Why it matters:
- Reduces CMS non-compliance penalties
- Eliminates duplicate or missing records
- Improves care coordination, referrals, and member search experience

Proven Data Enrichment Results:
99%
Average enrichment rate
Downstream Integration Without the Dev Headaches

Integrates quickly and reliably with EHRs, claims systems, and provider search tools. FHIR® 4.0.1 and proprietary APIs, real-time exports, and custom CSVs push data to any system. Easy to implement. No dev team required.

Modular Scalability

Deploy what you need now, and expand as requirements grow with Convergent’s flexible, modular platform that adapts to your organization’s evolving needs.

True AI-Driven Automation

Large Language Models (LLMs) power roster ingestion, schema mapping, validation, and enrichment. Provides real-time confidence scores and gets smarter every time. Faster decision-making and reduced manual workloads for your team.

Results:
96%
Increase in roster ingestion speed
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Core Use Cases

Find the right app or mix and match to deliver better service to members, maintain strong provider relationships, and ensure your data meets the highest standards of accuracy and compliance.

Provider Data Accuracy and Cleansing
Self-Service Provider Directory Management
Intelligent Provider Roster Automation
Compliance and Regulatory Automation (Regulatory Adapters)
Real-Time Provider Data Integration and Interoperability (Exports/APIs
Network Adequacy
Monitoring
Audit and Error
Reduction
National Provider Reference Data-as-a-Service APIs
Built-in Compliance Engines

Native support for No Surprises Act, ADA/Section 508, and CMS audit readiness built into the workflows. Automatically tracks, logs, and proves compliance.

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Consolidated Appropriations Act, 2023 Amendments:
  • Providers must include essential information: names, specialties, addresses, and telephone numbers.
  • Cultural and linguistic capabilities (including languages offered) must be listed.
  • Availability for new Medicaid and CHIP patients should be indicated.
  • Accommodations for physical disabilities must be detailed.
  • Provider internet websites (if applicable) should be included.
CMS Interoperability and Patient Access Final Rule:
  • Provider directory API based on HL7 FHIR standards is required.
  • Regular updates (at least every 30 days) ensure accuracy.
  • Public access without authentication or authorization is essential.
CMS 2020 Medicaid Managed Care Final Rule (CMS-2408-F):
  • Directories must be accessible to individuals with disabilities (ADA and 508 compliant).
  • “Mobile-enabled” directories (responsive mobile websites or apps) are necessary.
No Surprises Act:
  • Prompt updates (within 2 business days) upon receiving provider information changes.
  • Verification and updates at least every 90 days.
The Improving Seniors’ Timely Access to Care Act:
  • Regular verification and updates (at least every 90 days).
  • Easily accessible directories for beneficiaries (both online and in print).
Pricing

A modular, app-based pricing model enables you to address your most pressing needs on any budget.

Annual pricing (save 20%)
Contact sales for enterprise licensing cost
Customer Stories

See what customers are accomplishing with Convergent.

Erin Liberti
VP of Provider Relations, CenterLight Healthcare PACE
“Integrating Convergent to create a unified source of truth has drastically reduced the resources spent on managing fragmented provider data, benefiting members, providers, and internal teams alike. Their expertise in healthcare operations, innovative solutions, and dedicated support have driven measurable improvements in our efficiency and performance.”
Craig Behm
President, CRISP Shared Services
"Ensuring the accuracy and reliability of provider data is critical to our mission of supporting health information exchange across multiple states.  Our partnership with Leap Orbit has been instrumental in enabling CRISP Shared Services to clean, enrich, and push accurate provider data downstream to the services we provide clinical users, care coordinators and public health professionals."
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Frequently asked questions

Everything you need to know about the product and billing.