Overview

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Veradigm (formerly Allscripts Practice Management) provides cloud-based practice management and data analytics solutions serving thousands of ambulatory practices. Known for its robust billing capabilities, revenue cycle management, and real-world data insights through the Veradigm Network, Veradigm helps practices optimize financial performance while contributing to healthcare research. Stream Health's Veradigm integration enhances practice management workflows with clinical intelligence and systematic gap-in-care identification that drives both quality improvement and revenue growth.

With Veradigm's focus on practice financial health and healthcare data analytics, Stream Health provides complementary capabilities that translate clinical data into actionable revenue opportunities and quality measure compliance.

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Key features:

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• Practice Management Integration: Direct connectivity to Veradigm's practice management system retrieving patient demographics, insurance information, appointment scheduling, and financial data. Stream Health correlates clinical care gaps with billing opportunities and payer-specific quality incentives.

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• Revenue Cycle Intelligence: Integration with Veradigm's billing workflows to optimize claim submission and reimbursement. Stream Health identifies: undercoded services requiring documentation improvement, missed procedures eligible for billing, care gaps representing new billing opportunities, and payer-specific quality incentives maximizing contract value.

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• Real-World Data Enhancement: For practices participating in Veradigm's real-world data network, Stream Health provides enriched clinical data through external record consolidation—improving the completeness and accuracy of data contributed to research studies and quality reporting programs.

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• Financial Analytics: Correlation of clinical quality measures with financial performance. Stream Health enables practices to: track revenue generated from gap-in-care closure, measure ROI of quality improvement initiatives, identify highest-value care gaps by payer, and optimize staff allocation for maximum revenue impact.

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How it works

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Stream Health connects to Veradigm's practice management platform via API, retrieving patient demographic, insurance, scheduling, and financial data. For practices using Veradigm with an integrated EHR, we also retrieve clinical data; for practices using Veradigm PM with separate EHR systems, we consolidate data from both platforms.

Our platform enriches Veradigm data with external patient records from hospitals, specialists, and health information exchanges. This consolidated data undergoes AI + NP gap-in-care analysis identifying billable opportunities aligned with Veradigm's revenue cycle workflows.

Care gap findings integrate with Veradigm's practice management system, enabling: automated patient outreach campaigns for gap closure appointments, optimized scheduling to maximize visit revenue, pre-visit documentation templates for efficient gap closure, and real-time billing guidance with CPT codes and payer rules. Financial reports show gap-in-care revenue impact, quality incentive tracking, and staff productivity metrics—all accessible through Veradigm's existing reporting infrastructure.

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Benefits of integrating Veradigm with Stream Health

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• Practice Financial Optimization: Veradigm practices focused on revenue cycle performance gain systematic identification of $5M+ in annual billing opportunities from care gaps, underutilized services, and payer-specific quality incentives—enhancing Veradigm's existing revenue cycle capabilities.

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• Billing Workflow Integration: Stream Health's care gap findings integrate directly with Veradigm's billing processes, providing: pre-coded encounter templates for gap closure visits, medical necessity documentation supporting claims, CPT code recommendations with payer-specific rules, and estimated reimbursement for financial forecasting.

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• Payer Contract Optimization: For practices with value-based or quality-incentive contracts, Stream Health tracks performance against contract requirements, predicts year-end incentive payments, identifies highest-impact quality improvement opportunities, and provides patient-specific recommendations for meeting contract thresholds.

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• Real-World Data Contribution: Practices contributing data to Veradigm's research network benefit from Stream Health's external record consolidation, which improves data completeness for research studies, enhances quality measure accuracy for reporting, and provides additional context for clinical outcomes analysis.

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• Multi-EHR Environment Support: For practices using Veradigm PM with multiple or non-Allscripts EHR systems, Stream Health provides unified gap-in-care analysis across all clinical systems—consolidating fragmented data into actionable insights integrated with Veradigm's practice management workflows.