Before a payment goes out, Verity reads the whole public record, so that every dollar a health plan pays is a dollar it can defend.
Our ambition is that no health plan pays a provider the public record has already warned it about. We bring public enrollment, ownership, exclusion and spending records together into one picture, so that investigators see the pattern before the payment clears.
Each detector asks a different question of a different public record. A provider flagged by two of them independently is the strongest signal the system produces, and the ranking is built so that corroboration, not volume, rises to the top.
The score is a tier base, a bonus for every strong finding that reached the provider independently, and a bounded dollar term. Dollars at risk come from the detector that set the tier, count each provider once, and are never summed. Every row is a candidate for records review, not a finding.
Medicaid managed care plans, Medicare Advantage plans and commercial payers carry the loss when a ghost network bills them. Verity gives the teams that investigate, hold, contract and defend the same ranked list and the same evidence.
A ranked queue with the evidence already assembled, so records requests go out on day one instead of week three.
Hold the highest-tier candidates for review before a claim is paid, with the regulation behind each hold.
See the owners, formation dates and shared suites behind a new enrollment before signing a contract, and run the monthly list checks the rules require.
Packets describe records and dates, never intent, and every statement traces to a public dataset, so the file holds up when challenged.
No patient data and no claim lines leave your systems. Verity scores providers and networks from public records, and a person signs every action. Connect your own claims warehouse to hold payments before they go out.
Public federal and state records: Medicaid spending and enrollment, Medicare enrollments and owners, the national provider registry, exclusion and revocation lists, market saturation, quality data, Census geography, state lists and fee schedules.
Validate every provider number, repair encodings, standardize addresses, and work out which owner records are the same person with a probabilistic model fitted on the records, its merge rule checked against a sample a model adjudicated.
Three detectors with conservative assumptions and explicit tiers, evaluated against public labels with the uncertainty stated.
The packet is drafted from the evidence rows only, cites a record for every finding, and names the regulation each one relates to.
Reviewers accept or reject each packet. The decisions re-weight the evidence families behind the network score, so the ranking adjusts to what investigators confirm.
Built to be audited. Verity is designed for the compliance review that comes before any deployment inside a health plan.
Public provider-level datasets only. No patients, no claim lines, nothing beyond the public record.
Every packet is a draft for a reviewer, every action is signed by a person, and a deployment puts the console behind your identity provider.
Hosted today, or inside your own environment. The warehouse rebuilds from public files in minutes and refreshes weekly.
Every number traces to a public record, and the Methods page says what each evaluation can and cannot support.
A pilot takes one week. We run your state's providers through Verity and hand your investigations team a ranked queue with packets.
Request a Pilot