Best Provider Data Management (PDM) Software

CredentialStream® is a modern provider lifecycle management solution designed to simplify credentialing, privileging, and enrollment. Powered by hStream, it automates data gathering and validation, ensuring accuracy and compliance. Its modular design supports every stage of provider data management, from onboarding to evaluation.

The all-in-one credentialing solution, symplr Provider (formerly known as Cactus), takes care of everything from the initial application to ongoing recredentialing, which helps chief medical officers of large, multi-facility health systems speed up onboarding, so physicians can start caring for patients and bill for services sooner.  symplr Provider is a cloud-based solution that helps credentialing teams manage the entire provider lifecycle, from initial application to ongoing credentialing. This centralized credentialing system becomes the single source of truth for provider data, helping teams reduce redundancy, improve provider satisfaction, maintain compliance, and speed up onboarding and enrollment timelines.   Features that streamline provider credentialing • End-to-end solution: Manage credentialing, privileging, provider enrollment, OPPE, and provider performance all from one connected system. • Credentialing automation: Easily connect to primary sources and regulatory databases to verify credentials. • Easier privileging process: Access extensive library of 9,600+ delineated privileges with embedded ICD/CPT codes for faster privilege list development and deeper data analytics. • Provider enrollment management: Proactively track providers through the enrollment process and easily generate rosters, including added, deleted, and changed data. Benefits of symplr Provider • Improve provider satisfaction: Create a smoother onboarding experience that improves provider satisfaction. With symplr, providers upload their credentialing documents once and share them across all entities in the health system—saving time and avoiding duplicate work. • Eliminate bottlenecks across the credentialing lifecycle: Speed up every stage of provider credentialing—from application to committee review—with automation that replaces spreadsheets and manual handoffs. • Strengthen compliance and decision-making: Unify credentialing with performance data to meet regulatory requirements and inform privileging and reappointment decisions.

From the first phone call with a new patient through final claim reconciliation and payment, you need a simpler way to collect, submit, and track the administrative, clinical, and financial data that make healthcare possible. Availity Essentials is the place to connect with your payers—at no cost to providers. Availity works with hundreds of payers nationwide to give providers a one-stop-portal where they can check eligibility, submit claims, collect patient payments and track ERAs, and even sign up for EFT. Your Essentials account gets you access to all this and more, with one password. You can also update your provider profiles, manage quality-of-care paperwork, and get detailed reporting about your office’s standard HIPAA and other payer transactions.

Medallion is the leading provider network management platform that unites provider operations and empowers end-to-end automation for credentialing, enrollment, and monitoring. We free healthcare teams to focus on what matters by enabling healthcare organizations to quickly and accurately manage and grow their provider networks with our AI-powered automation technology.

Verifiable is a pre-built credentialing and network monitoring solution built to help provider, health plans, and pharma organizations optimize operations with error-free, fast verifications at scale and to stay compliant with ease. Our architecture was built to connect network teams, systems, and data from day one. Verifiable has real-time integrations to 3200+ trusted verification sources and automated workflows to enable NCQA-compliant verifications, documentation, and reporting. Our solutions are backed by our in-house credentialing and compliance experts. They bring a combined 60+ years of experience, are all NCQA certified, and we maintain a 100% CSAT score. Whether insourcing or outsourcing, we provide best-in-class support. We work with you to build a business case with an actionable strategy for quick wins and long-term impact. We’ve helped customers achieve up to a 98% reduction in credentialing turnaround times and millions of dollars in immediate savings.

Verisys is an online credentialing and management tool. It uses trusted data to help protect patients, sustain your reputation, ensure compliance, and speed onboarding. The MedPass is created from the CheckMedic process and is an all-inclusive, portable profile.

Eliminate revenue loss with an automated, intelligent solution that handles every iteration of contracting, pricing, rebating, indirect channel processing, and compliance around regulatory and contractual obligations. Model N bridges the gap between front-office and back-office processes to eliminate silos; standardizes processes across divisions, regions, and markets; delivers insight to drive strategy and revenue. For more information visit: www.modeln.com

Up-to-date integrated provider directory software - delivering credentialed, referring, and affiliated provider data. Continuously curated and integrated with EHR, digital front door, patient access, revenue cycle, and other systems. (Formerly known as Phynd). It facilitates: - Provider data management across the enterprise - Consumer-friendly external and internal directories - Real-time referring provider enrollment in the EHR - Provider search and seamless appointment scheduling

symplr Payer is a provider data management and payer credentialing platform designed for health plans, managed care organizations, and payer networks that require accurate, validated provider information across credentialing, compliance, and network operations. Developed by symplr, a U.S.–based healthcare operations technology company, the product supports teams responsible for maintaining provider data integrity, coordinating credentialing and enrollment workflows, and meeting regulatory requirements that affect member access and reimbursement. The platform unifies credential lifecycle management, automated primary source verification, and centralized provider data governance. symplr Payer consolidates demographic, licensure, training, affiliation, and network participation details into a verified single source of truth that integrates with downstream systems. Users can track expirables, receive automated regulatory alerts, manage onboarding and recredentialing processes, generate audit-ready reports, and ingest validated payor source data to maintain accuracy at scale. The system also supports directory management, network adequacy reporting, and data sharing with claims, enrollment, and revenue cycle applications. For payer organizations, symplr Payer helps standardize and streamline payer credentialing workflows, reduce administrative backlogs, and ensure compliance with CMS, NCQA, and No Surprises Act requirements. Maintaining complete and current provider profiles reduces delays in network readiness, improves directory and claims data reliability, and strengthens coordination across credentialing, provider relations, compliance, and revenue cycle teams. By improving consistency and reducing manual verification tasks, the platform supports operational efficiency and lowers compliance risk. Payers use symplr Payer to maintain accurate provider data, optimize credentialing and recredentialing processes, and ensure information remains validated and consistent across all systems involved in network management and reimbursement activities.

CAQH ProView®, the trusted source and industry standard for self-reported provider data, is used by more than 1.4 million healthcare providers. CAQH ProView continues to be the premier credentialing tool, but can now also be used by participating organizations for network directories, claims processing, quality assurance, emergency response, member services and more.

VerifyHCP is a groundbreaking provider data management and provider directory compliance solution that goes beyond answering federal and state regulations.