Convergent

Provider Data Management Software

Turn fragmented provider data into a unified, accurate, and interoperable asset that drives efficiency and compliance.

The Operating System for Provider Data Management

Built for health plans of all sizes, Convergent powers the entire provider data lifecycle—ingestion, integration, enrichment, and distribution—to deliver accuracy, compliance, and efficiency at scale. Our modular platform adapts to your needs, enabling you to deploy individual solutions or the full system for a comprehensive, low-cost, low-risk approach.

Get Started with Convergent

Overview

Why Convergent?

Convergent is an app-based, scalable ecosystem that automates provider data operations, enabling health plans to streamline processes, enhance network accuracy, and remain compliant.

Compliance Assurance

Exceed regulatory standards with fast, AI-powered updates, built-in accessibility, and audit trails to minimize risk and ensure compliance.

Results:

96%

Increase in roster ingestion speed

Real-Time Data Integrity

Standardization, deduplication, and enrichment processes consolidate disparate data sources into a single, reliable provider “golden record” and source of truth for all your provider data across the enterprise. Maintain continuously updated provider information, reducing the risk of outdated or ghost providers and ensuring timely, accurate updates across your network.

Results:

99%

Average enrichment rate

Seamless Interoperability

One-stop-shop for all your provider data integration needs. Integrates quickly and reliably with EHRs, claims systems, and provider search tools using FHIR® 4.0.1 and proprietary APIs, as well as file-based integrations with any format, enabling interoperability across all your systems.

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.

Speed and Efficiency

Accelerates roster ingestion and processing, enabling faster decision-making and reducing manual workloads for your team.

Results:

73%

Time saved per employee per quarter

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

Compliance

Meet regulatory and operational standards and minimize risk because Convergent is and always will be compliant with the growing list of provider directory rules:

direct-trust-accreditation-ehnac-standard-regulatory

section-508-compliant-standard-regulatory

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."

Frequently asked questions

Everything you need to know about the product and billing.

Provider Data Management Software

Turn fragmented provider data into a unified, accurate, and interoperable asset that drives efficiency and compliance.

An End-to-End Solution for Provider Data Integration

Why Convergent?

Core Use Cases

Convergent App-Based Ecosystem

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

See what customers are accomplishing with Convergent.

Frequently asked questions