Medversant
Medversant is a privately held healthcare technology company providing NCQA- and URAC-accredited provider data management services to health plans, Medicaid agencies, and pharmacies, using patented AutoVerif*i*™ technology for automated primary source verification.
- Company typePrivate
- Founded1999
- HeadquartersLos Angeles, United States
- Headcount11–50
- GTM typeB2B
- OfferingServices
What Medversant does
Medversant Technologies, LLC is a privately held healthcare technology company founded in 1999 and headquartered in Burbank, California, that provides provider data management services to health plans, public-sector Medicaid agencies, pharmacies/PBMs, and provider groups. The company's core platform is the ProviderIQ™ suite, built around its patented AutoVerif*i*™ technology (U.S. Patent 7529682), which automates primary source verification across more than 100 federal and state data sources in real time and captures date-stamped images from each. The suite bundles modules for primary source credentialing, provider directory management, network enrollment, network adequacy, virtual review committee, non-responder outreach, and claims screening, with adjacent products LicenseSource™ (state licensing and Medicaid enrollment) and RxMonitored™ (pharmacy/PBM roster verification under 42 CFR Part 455, Subpart E).
Since founding, Medversant has credentialed or screened more than 4.2 million providers from over 250 (some sources cite 300+) healthcare organizations, and claims a guarantee of at least 95% provider data accuracy. The company operates on a services-not-software model: pricing is value-based and customized per client rather than packaged, contracts are multi-year, and delivery runs through a shared web-based platform combined with U.S.-based provider outreach staff. Its core regulatory credentialing credentials — NCQA CVO certification across all ten available categories and URAC CVO accreditation — underpin procurement access to health plans and Medicaid fiscal intermediaries, including a referenced 6-state fiscal intermediary engagement and deployments for organizations such as the Michigan Department of Community Health.
Medversant firmographics
Firmographics- Name
- Medversant
- Legal name
- Medversant Technologies, LLC
- Website
- https://medversant.com
- Company type
- Private
- Founded year
- 1999
- Operating status
- Operating
- Headcount range
- 11–50 employees
- Short description
- Medversant is a privately held healthcare technology company providing NCQA- and URAC-accredited provider data management services to health plans, Medicaid agencies, and pharmacies, using patented AutoVerif*i*™ technology for automated primary source verification.
- Ownership category
- akta.pro rank
Medversant industry classification
Industry- Product category
- Healthcare Provider Data Management
- NAICS
- Ambulatory Health Care Services (621)
- SIC
- Services-Health Services (8000), Hospital & Medical Service Plans (6324)
- akta.pro primary industry
- Healthcare Master Data Management (MDM) & Patient/Provider Identity Data (HLACAIAB)
- akta.pro secondary industry
- Provider Credentialing, Licensing & Compliance Enablement (multi-state) (HLALAKAM)
Keywords
Where Medversant is headquartered
LocationHeadquarters
- HQ city
- Los Angeles
- HQ country
- United States
- HQ region
- North America
Offices1 record
Markets served
Medversant business model
Business model- GTM type
- B2B
- Offering type
- Services
- Cost components
- Personnel, Operations, Technology or R&D, Marketing or Sales, Others
Revenue model
- Provider Data Management Services: Medversant operates on a services model, not software licensing. The company provides specialized services through a shared web-based platform, delivering value from day one. Pricing is value-based and customized according to client needs rather than static packaging. The company serves healthcare organizations through credentialing, verification, and ongoing monitoring services.
- Credentialing & Verification Services: NCQA-certified and URAC-accredited CVO services performing credentials verification, reporting credentialing information to clients, and protecting information integrity and confidentiality. Includes primary source verification for DEA, licenses, education, malpractice history, sanctions, and ongoing monitoring.
Pricing tiers
| Model | Billing | Price |
|---|---|---|
| Subscription | Multi-year contract | Custom value-based pricing |
Go-to-market motion1 record
Distribution channels2 records
Marketing channels4 records
Medversant product offering
Product offeringCore offering
Medversant provides healthcare provider data management and credentialing services delivered through the ProviderIQ™ web-based platform. The company automates primary source verification of provider credentials, licenses, sanctions, DEA, education, and contact data using its patented AutoVerif*i™ engine, and delivers managed credentialing, provider directory, network enrollment, network adequacy, claims screening, pharmacy data verification (RxMonitored™), and state licensing (LicenseSource™) services to health plans, government agencies, PBMs, and providers.
Product overview
Medversant offers a unified provider data management platform built around the ProviderIQ™ suite, which includes multiple integrated modules: Primary Source Credentialing, Provider Directory, Network Enrollment, Network Adequacy, Virtual Review Committee, Non-Responder, and Claims Screening solutions. Additional products include LicenseSource™ for state healthcare provider licensing and RxMonitored™ for pharmacy data verification. ProviderSource™ serves as the provider-facing application portal. The company follows a services-not-software model delivered through a shared web-based platform with value-based pricing, enabling healthcare organizations to centralize, standardize, automate, and integrate provider information.
Differentiator
Problem solved
Functional benefit
Brands
- ProviderIQ™: Suite of applications enabling healthcare organizations to power their provider data processes efficiently with accurate data, including Network Enrollment, Primary Source Credentialing, Virtual Review Committee, Network Adequacy, Provider Directory, Non-Responder, and Claims Screening solutions.
- LicenseSource™
- RxMonitored™
- ProviderSource™
- AutoVerif*i*™
- ClaimGard™
- OneSource
Products and services
- ProviderIQ™ Suite of web-based applications for healthcare provider data management, including primary source credentialing, provider directory management, network enrollment, network adequacy, virtual review committee, non-responder management, and claims screening, serving health plans, government agencies, and providers.
- LicenseSource™ Web-based licensing and enrollment solution for state healthcare providers that connects state license data with Medicaid enrollment, screening, and credentialing activities; supports license applications, renewals, and fee collection.
- RxMonitored™ Pharmacy data verification and continuous roster management solution for pharmacies and PBMs, integrating NCPDP dataQ® data to ensure compliance with 42 CFR Part 455, Subpart E and reduce risk of fines and audits.
- ProviderSource™ Free paperless web portal that enables providers to manage credentialing documents for entire offices with auto-population and conformity to specialty and state requirements.
- AutoVerif*i™ (U.S. Patent 7529682) Patented cost-effective automated verification solution that captures data from primary sources with date-stamped images and enables verification of 100+ data sources in real time; built for federal/ACA regulations at 42 CFR 455.410 and 42 CFR 455.450.
- ClaimGard™ Claims screening solution that ensures claims are submitted by qualified providers who are licensed and without sanctions, providing verified provider information based on date of service or date of payment, with integration into existing fraud detection processes.
- OneSource for Providers Provider data management solution enabling provider credentialing and centralized data management, later superseded within the ProviderIQ™ suite.
Quantifiable outcome
- 95% provider data accuracy guaranteed
- +3 more outcomes
Companies that use Medversant
Customer profileNamed customers2 records
Segments4 records
Ideal customer profiles4 records
Medversant technology and API
TechnologyTechnology focussed Yes
API detail
- Has API
- No
- API docs
- API detail
Core technology
AI maturity
App detail
Integration2 records
Feature6 records
Medversant partnerships and signals
Strategic signalPartnerships
One partnership is on record.
- NCQA (National Committee for Quality Assurance)coreMedversant is an NCQA-verified Credentials Verification Organization (CVO) holding certification in all ten available CVO categories. The NCQA certification validates Medversant's credentials verification services, reporting capabilities, and information integrity/confidentiality protections.
Scale indicators10 records
Recent moves6 records
Expansion highlights5 records
Medversant competitors and assessment
Company assessmentDirect peers
- symplr: symplr is a healthcare governance, risk, and compliance platform that bundles credentialing (via Cactus, Midas+, and Provider), provider data, and payer services — directly overlapping Medversant's ProviderIQ™ suite for health systems, payers, and providers.
- HealthStream (VerityStream): HealthStream's VerityStream business is one of the largest enterprise credentialing and provider lifecycle management vendors, directly competing with Medversant's Primary Source Credentialing and Virtual Review Committee modules for hospitals, health plans, and MSOs.
- MD-Staff (Applied Statistics & Management): MD-Staff is a long-standing medical staff credentialing and privileging software platform used by hospitals and health systems, competing directly with Medversant's credentialing and VRC solutions for provider lifecycle management.
- CAQH: CAQH operates the widely adopted CAQH ProView provider data platform, directly competing with Medversant's ProviderIQ™ in the provider credentialing, directory, and primary source verification space, particularly for health plans.
Broad incumbents
- LexisNexis Risk Solutions: LexisNexis provides provider data, sanctions monitoring, and identity verification at scale through its healthcare data business, overlapping with Medversant's continuous monitoring and primary source verification capabilities for payers and PBMs.
- Cognizant (TriZetto Provider Solutions): Cognizant's TriZetto provider solutions include credentialing, network management, and provider data services for payers, with overlapping capabilities to Medversant's ProviderIQ™ and Network Enrollment modules at large enterprise scale.
Emerging players
- Proximal Health: Proximal Health focuses on network adequacy, provider directory, and regulatory compliance for payers, competing with Medversant's Network Adequacy and Provider Directory modules for state and federal regulatory use cases.
- Ribbon (formerly CredentialMyDoc): Ribbon provides provider data accuracy, directory management, and network solutions for health plans, digital health companies, and providers, with overlapping capabilities to Medversant's Provider Directory and data accuracy modules.
- Andros (Northstar / Andros Inc.): Andros specializes in provider network data exchange, directory management, and onboarding for payers and providers, with meaningful overlap to Medversant's Provider Directory, Network Enrollment, and LicenseSource offerings.
Others
- Surescripts (Mastermind/Provider Data): Surescripts operates nationwide health information networks that touch provider data and eligibility, offering adjacent capabilities to Medversant's verification and pharmacy compliance products like RxMonitored™.
Market position
Strengths4 records
Weaknesses4 records
Competitive moat5 records
Key risks6 records
Key highlights7 records
Customer concentration
Medversant social profiles
Digital presenceMedversant compliance and trust
Trust signalCompliance6 records
Medversant financial estimates
Financial estimateRevenue estimate
Valuation estimate
Medversant leadership team
Management profileNumber of profiles
Profiles1 record
Medversant funding detail
Funding detailFunding overview
Funding rounds1 record
Investors
Funding detail is available on the Subscription and Enterprise plan.Contact sales →
Medversant M&A and investment
M&A and investmentM&A
Investments
M&A and investment is available on the Subscription and Enterprise plan.Contact sales →
Frequently asked questions about Medversant
What does Medversant do?
Medversant provides healthcare provider data management and credentialing services delivered through the ProviderIQ™ web-based platform. The company automates primary source verification of provider credentials, licenses, sanctions, DEA, education, and contact data using its patented AutoVerif*i™ engine, and delivers managed credentialing, provider directory, network enrollment, network adequacy, claims screening, pharmacy data verification (RxMonitored™), and state licensing (LicenseSource™) services to health plans, government agencies, PBMs, and providers.
Is Medversant a public or private company?
Medversant is a private company. It is classified as unknown and is currently operating.
When was Medversant founded?
Medversant was founded in 1999. It employs 11 to 50 people.
Where is Medversant based?
Medversant is headquartered in Los Angeles, United States, in the North America region.
How does Medversant make money?
Two revenue lines are on record. Provider Data Management Services are the primary driver. The others are credentialing & Verification Services.
Who are Medversant's main competitors?
Direct peers on record are symplr, HealthStream (VerityStream), MD-Staff (Applied Statistics & Management) and CAQH. Broad incumbents are LexisNexis Risk Solutions and Cognizant (TriZetto Provider Solutions). Emerging players are Proximal Health, Ribbon (formerly CredentialMyDoc) and Andros (Northstar / Andros Inc.). Surescripts (Mastermind/Provider Data) is listed as an others.
Does Medversant have an API?
No public API is recorded for Medversant.
What industry is Medversant in?
Medversant's product category is Healthcare Provider Data Management. Its primary akta.pro industry code is HLACAIAB, Healthcare Master Data Management (MDM) & Patient/Provider Identity Data, with a secondary code of HLALAKAM, Provider Credentialing, Licensing & Compliance Enablement (multi-state). Its NAICS code is 621 and its SIC code is 8000.