Top 10 LexisNexis Alternatives for Provider Data Management

Looking for LexisNexis alternatives for efficient provider data management? You’re on the right page.

While LexisNexis is touted as a reliable solution for provider data management, there are other options that can automate the tedious tasks of validating and maintaining provider data. This can help healthcare professionals ensure patients receive care from credentialed providers, mitigate compliance risk, and effectively perform essential business functions.

This blog post reviews the 10 best LexisNexis competitors and alternatives for effective provider data management.

What is LexisNexis Provider Data Management Software?

LexisNexis is a comprehensive solution that helps healthcare organizations maintain accurate provider information while ensuring compliance with state and federal regulations.

It simplifies the complex task of verifying credentials, data validation, updating demographics, and cleansing provider records. The software automates these processes to enhance operational efficiency, minimize errors, strengthen communication between care teams, and improve patient experiences.

LexisNexis Alternatives At a Glance

Here is a quick comparison of the top LexisNexis Alternatives known for their efficient provider data management capabilities:

10 Best LexisNexis Alternatives for Provider Data Management

Let’s explore the top competitors of LexisNexis in detail.

1. PRIME® by Atlas Systems

PRIME® by Atlas Systems is the leading alternative to LexisNexis for provider data management delivering unparalleled provider data accuracy and compliance for healthcare payers. 

At Atlas Systems, we understand that ensuring provider data integrity is critical, as inaccuracies can result in regulatory penalties, operational inefficiencies, and negative patient experiences. 

Our software mitigates these risks by utilizing direct provider outreach, primary source validation, and AI-powered analytics to maintain up-to-date, verified provider records which results in a 95% success rate in data accuracy.

Unlike other LexisNexis alternatives that primarily rely on aggregated data sources, PRIME® prioritizes real-time validation through active engagement with health systems and providers. 

This reduces errors, minimizes provider abrasion, and enhances regulatory compliance with CMS, CA SB137, and the No Surprises Act. Besides, our platform is compatible with Fast Healthcare Interoperability Resources (FHIR) which enables seamless integration and data exchange across healthcare ecosystems.

Key features

Here are the standout features that make PRIME® the best LexisNexis alternative:

• Provider data validation at the source: We ensure data accuracy by contacting healthcare provider groups, individual practitioners, and other key players to validate patient information directly at the source. This approach minimizes errors and discrepancies while ensuring compliance with regulations.
• Self-service portal (SSP): Our software simplifies provider data management by offering an intuitive, Excel-like interface. You can easily review, update, and correct data, reducing manual errors and improving validation speed. 
• AI-driven Ask PRIME®: The Ask PRIME® feature uses artificial intelligence and allows you to ask questions about your data and answers in seconds. 
• AI-powered dashboard: The PRIME® browser-based dashboard is an all-in-one window that provides a centralized view of your data findings and attestation progress in near real-time. This feature enables you to monitor key metrics effectively and make timely interventions when necessary.
• FHIR compatibility: Our software is compatible with Fast Healthcare Interoperability Resources (FHIR) and facilitates seamless integration and data exchange across various healthcare systems for streamlined workflows.

See what our customers say about our software:

Pricing

Atlas Systems offers customized pricing depending on your provider data management needs. Contact our team directly for tailored pricing.

2. CredentialStream by HealthStream

As another contender among LexisNexis alternatives, CredentialStream is designed for healthcare payers and providers to streamline credentialing, privileging, and network management. 

The software offers automated workflows for you to request, gather, and validate provider information to ensure accurate and compliant data.

Unlike some LexisNexis competitors, CredentialStream provides an integrated solution with best-practice content libraries and industry-leading datasets. 

Features like Bolt and hStream enhance real-time data exchange, while The Hub centralizes provider lifecycle management.

Key features

Some important features of CredentialStream include:

• Automated credentialing & privileging: CredentialStream simplifies the credentialing process by automating the collection, verification, and monitoring of provider credentials. It ensures compliance with industry regulations while reducing administrative workload.
• Real-time data insights: The software uses industry-leading datasets and analytics to provide real-time insights into provider data. It continuously updates credentialing and privileging information, helping healthcare payers mitigate risks, improve decision-making, and ensure regulatory compliance.
• Centralized provider lifecycle management: It offers The Hub which acts as a centralized platform for managing the entire provider lifecycle. It organizes provider information from initial enrollment to performance evaluations, ensuring seamless data accessibility.

Pricing

CredentialStream offers customized pricing based on your credentialing needs. Contact support for customized pricing.

3. Availity 

Availity is another LexisNexis alternative for provider data management software, offering healthcare payers a solution to maintain accurate provider directories. 

Compliance with regulations like the No Surprises Act requires up-to-date provider data, and Availity simplifies this process by integrating directly into provider workflows. 

The platform ensures real-time data monitoring, comparing updates from provider networks and third-party sources against a payer’s “golden record.” It reduces the administrative burden through automated notifications and streamlined attestation, which enhances data accuracy while minimizing provider abrasion. 

Key features

Some key features of Availity provider data management software include:

• Real-time provider data monitoring: Availity continuously tracks provider demographic data by pulling daily updates from provider networks and third-party sources. This data is compared against a payer’s “golden record” to ensure accuracy. 
• Automated attestation and workflow integration: To reduce provider abrasion, the software integrates directly into provider workflows, allowing administrators to review, correct, and attest to data efficiently. It also provides automated notifications to ensure that only the right contacts receive update requests, minimizing unnecessary outreach.
• Compliance with provider directory mandates: Availity helps healthcare organizations stay compliant with state and federal regulations requiring accurate provider directories. Payers can proactively manage data validation and provider updates to avoid penalties and improve member experiences.

Pricing

Availity offers tailored pricing based on your needs. Fill out the provided form to get customized pricing.

4. symplr Provider

symplr Provider is a popular provider data management software among the LexisNexis alternatives for healthcare organizations. It is designed to centralize provider data, and streamline credentialing, payer enrollment, privileging, and contracting. 

Unlike other LexisNexis competitors, symplr Provider connects critical provider workflows, ensuring accurate and up-to-date data across electronic health records, claims, and directories.

The platform accelerates reimbursement by automating payer enrollment and compliance processes. Additionally, symplr’s cloud-based infrastructure enhances security while optimizing efficiency for healthcare payers and providers. 

With seamless integration and workflow automation, symplr Provider simplifies provider data management, enabling organizations to improve compliance, reduce administrative burden, and enhance patient care quality.

Key features

Here are the key features of symplr:

• Centralized provider data management: symplr consolidates all provider information into a single, secure platform, ensuring data accuracy and accessibility across various healthcare systems. 
• Automated credentialing and enrollment: The platform automates credentialing processes and payer enrollment to expedite provider onboarding while maintaining compliance with industry standards.  
• Continuous quality improvement tools: symplr includes tools for ongoing performance monitoring and quality improvement initiatives to help healthcare organizations enhance patient care outcomes and meet regulatory requirements effectively.

Pricing

symplr offers customized pricing based on provider data management and credentialing needs. Contact support for customized pricing.

5. Verisys

As a provider compliance data solution, Verisys offers tools tailored for healthcare payers and providers. The platform specializes in delivering real-time, verified data to streamline compliance, credentialing, and risk mitigation processes. 

With over 99.95% accuracy, Verisys outperforms other LexisNexis competitors by ensuring pristine, actionable data for sanctions monitoring, licensure verification, and payment integrity. 

Its scalable solutions support all provider types, automating updates and reducing credentialing lapses. The software also ensures compliance with standards like NCQA, URAC, and The Joint Commission.

Key features 

Here are key features of Verisys

• Real-time provider data verification: Verisys delivers real-time, verified provider data to ensure compliance with healthcare regulations.
• Continuous provider monitoring: The platform offers monitoring solutions that track provider credentials, sanctions, exclusions, and license updates.
• Master provider data management: Verisys streamlines provider data management by cleansing, normalizing, and augmenting large datasets. This process supports provider directories, enrollment reporting, and prescriber verification.

Pricing

Verisys offers customized pricing based on your specific needs. Contact support for tailored pricing.

6. Medallion 

Medallion’s ability to sync data across entire healthcare systems makes it a popular solution among LexisNexis competitors.

Unlike other LexisNexis alternatives that employ manual data processes that lead to inefficiencies, compliance risks, and revenue delays, Medallion centralizes provider data to eliminate errors and reduce administrative burden. 

It also offers real-time data updates and automated validation to ensure compliance and minimize claim denials. 

Key features

Some notable features of Medallion provider data management include:

• Automated provider data updates: Medallion eliminates manual data entry by automatically updating provider records in real time. 
• Compliance and data accuracy: The software provides built-in validation tools to ensure provider records meet regulatory requirements and reduce data compliance risks. 
• Seamless system integration: The platform synchronizes provider data across multiple healthcare platforms to ensure data consistency across all systems.

Pricing

Medallion offers scalable pricing based on your specific provider data management needs. Contact support to get a customized quote that aligns with your organization

7. Coperor by Gaine

As one of the LexisNexis alternatives, Gaine’s Coperor platform is designed to help healthcare providers and payers maintain accurate, up-to-date provider information.

It centralizes provider data across credentialing, contracting, and network management systems to reduce inefficiencies and compliance risks. 

The software automates roster reporting, accelerates provider onboarding, and ensures regulatory compliance by validating data against trusted sources like CMS, CAQH, and state licensure boards. 

Key features

Here are noteworthy features of Coperor:

• Automated roster reporting: Coperor streamlines provider data updates by automating roster reporting. You can upload your health plan rosters to a portal; the software validates and processes the data. 
• Centralized data management: The platform allows healthcare payers to manage provider data from a single source and distribute updates across multiple systems.
• Advanced data governance and compliance: Coperor validates provider data against trusted sources like CMS, CAQH, and state licensure boards. It applies business rules to prevent conflicts, maintain data integrity, and ensure regulatory compliance.

Pricing

Medallion pricing is customizable. Contact support for tailored pricing.

8. Orderly

Orderly offers healthcare organizations a reliable alternative to LexisNexis. The platform uses AI-powered technology and a vast network of public, partner, and proprietary data sources, to ensure accurate, transparent, and regularly updated provider directories. 

Unlike some LexisNexis competitors, it provides traceable data updates and record-level justifications, enhancing compliance with the No Surprises Act. Its automated functionality reduces operational costs and minimizes provider data errors. 

Key features

Here are useful features of Orderly.

• AI-enabled provider data updates: Orderly leverages advanced AI technology to validate, clean, and update provider data with precision. It utilizes public, partner, and proprietary data sources, it ensures healthcare organizations maintain accurate directories. 
• Automated directory error detection: The software uses automated scanning to identify and correct provider directory errors to help healthcare organizations maintain up-to-date records, close data gaps, and enhance the member experience.
• Regulatory compliance and phone attestation: Orderly helps organizations comply with the No Surprises Act and the Consolidated Appropriations Act of 2021.

Pricing

Contact support for customized pricing.

9. Perspecta PDM

Perspecta PDM offers handy provider data management solutions, serving as an ideal alternative to LexisNexis for healthcare organizations. 

Their services include provider data cleansing, provider DataVault, provider roster management, and Provider Directory Solutions, all designed to enhance data accuracy and integrity.

The platform employs machine learning and AI-enabled master indexes to ensure continuous updates and compliance with state and federal regulations. 

This approach reduces resource needs, mitigates risks associated with data inaccuracies, and improves overall provider network management efficiency.

Key features

Some notable features of Perspecta include:

• Provider data cleansing: The software ensures accurate and up-to-date provider information by eliminating errors and inconsistencies.
• Provider DataVault: It securely stores and manages provider data, facilitating efficient access and maintenance while ensuring compliance with regulatory standards.
• Provider roster management: Perspecta streamlines the organization and maintenance of provider rosters to improve network management and ensure alignment with organizational goals.

Pricing

Perspecta offers tailored pricing based on your provider data management needs. Contact support for customized pricing.

10. Kyruus Connect

Kyruus Connect closes our list of LexisNexis alternatives. The provider data management software is designed to help healthcare organizations centralize and optimize provider data. 

It ensures accurate, reliable provider information for health systems and health plans. 

Unlike other PDM software solutions that use fragmented data sources, Kyruus Connect creates a single source of truth to improve operational efficiency and patient access to care. 

The software’s intuitive provider directory empowers patients to find the right providers based on availability, insurance, and location.

Key features

Here are the key features of Kyruus Connect

• Centralized provider data management: Kyruus Connect unifies fragmented provider data into a single source of truth to ensure accuracy across health systems and health plans.
• Comprehensive provider directory: With an intuitive provider directory, Kyruus Connect simplifies the search process for patients and members. Users can filter providers based on availability, insurance, specialty, and location to find the right care with ease.
• Regulatory compliance & data accuracy: The software helps you maintain regulatory compliance by keeping provider data accurate and up to date. This ensures that health plans and systems meet industry standards while providing reliable provider information for enhanced patient experiences and operational effectiveness.

Pricing

Kyruus Connect offers tailored pricing for healthcare providers and payers. Contact support for customized pricing.

Why Choose LexisNexis Alternatives?

While LexisNexis is touted as the industry leader in provider data insights, you may consider its alternatives for the following reasons:

High cost and pricing concerns

LexisNexis can be expensive, especially for smaller organizations, startups, or those with limited budgets.

Many alternatives to LexisNexis offer competitive pricing models, with more flexible subscription plans or pay-as-you-go options. 

These alternatives also offer similar provider data validation capabilities without requiring large financial commitments. 

If you’re looking to cut operational costs without sacrificing data quality, switching to LexisNexis replacements can be a financially smart move.

Concerns about data accuracy and freshness

While LexisNexis provider data management software offers a vast database of healthcare professionals and organizations, some users report issues with outdated or incomplete provider records. 

Inaccurate provider data can lead to compliance issues, claim denials, and inefficiencies in patient referrals. According to Gartner, poor data quality costs organizations an average $12.9 million, every year.

Fortunately, many LexisNexis provider data enhancement alternatives focus on real-time data updates, AI-driven validation, and automated data cleansing, ensuring that provider details remain accurate and up to date. 

Some LexisNexis competitors even offer direct integrations with National Provider Identifier (NPI) registries, medical licensing boards, and healthcare networks to ensure continuous updates.

Limited customization and workflow flexibility

Every healthcare organization has unique needs when it comes to provider data management. While LexisNexis provider data validation software offers structured solutions, some businesses find its customization options too rigid for their specific workflows.

Many LexisNexis competitors provide highly customizable data management solutions, allowing you to define your own rules, create tailored workflows, and set up automated alerts for data changes. 

If you need more control over how your provider data is collected, validated, and used, switching to a LexisNexis alternative can be a great idea.

Complex integration with existing systems

Integrating LexisNexis provider data management software with electronic health records (EHRs) claims management systems, and CRM platforms can sometimes be complex, especially for provider staff with limited tech skills. 

Besides, some users report issues with compatibility, slow data synchronization, and the need for extensive IT support.

Luckily, many alternatives to LexisNexis offer easier integration through API-driven solutions, cloud-based platforms, and no-code or low-code tools. These options allow you to connect provider data with your existing systems which can improve efficiency and reduce IT overhead.

Compliance and regulatory challenges

Healthcare regulations, such as HIPAA, CMS, and NCQA guidelines require organizations to maintain accurate and compliant provider data.

While LexisNexis provider data validation software helps meet these standards, some organizations need more specialized compliance features to address their specific regulatory needs.

Some alternatives to LexisNexis offer built-in compliance checks, automated regulatory reporting, and tailored features for regional and industry-specific requirements. 

Lack of search history and ongoing monitoring capabilities

LexisNexis provider data management software does not retain your search history. Here is one user complaining about the same. 

This means that once you perform a search, the software doesn’t save the results for future reference. As a result, you cannot track changes, monitor updates, or receive alerts when provider data changes over time.

If you need to continuously monitor provider credentials, licensing updates, or other critical data, this lack of historical search tracking can be a major drawback.

The good news? Some LexisNexis competitors offer solutions with ongoing monitoring, automated alerts, and periodic re-verification of provider data. This helps you stay up to date with real-time changes which reduces manual workload while improving compliance.

Steep learning curve and training required for advanced features

While LexisNexis provider data management solution offers powerful tools for data validation, compliance checks, and provider directory management, you need extensive training to fully utilize these features.

If you’re a new user you may struggle with the platform’s interface, data filtering options, and reporting tools which can lead to a longer onboarding process. Further, for organizations with limited IT support or smaller teams, the need for additional training can slow down adoption and increase operational costs.

Fortunately, some LexisNexis competitors provide more user-friendly dashboards, intuitive workflows, and built-in guidance, making it easier to manage provider data without extensive technical training. 

Ultimately, while LexisNexis remains a widely used solution, it isn’t always the best fit for every organization. There are many alternative solutions for provider data management out there you may want to consider.

Factors to Consider When Researching Alternatives To LexisNexis

When evaluating LexisNexis alternatives for provider data management evaluate several key factors such as data accuracy and quality, data security and compliance, integration capabilities, scalability, user experience, and support. Doing this will help you choose a solution that meets your organization’s needs.

Let’s break down these factors in depth.

Data accuracy and quality

When selecting LexisNexis competitors for provider data management software, prioritize platforms that ensure high data accuracy and reliability. Inaccurate provider data can lead to claim denials, compliance risks, and operational inefficiencies. 

Look for solutions with advanced data cleansing, validation, and enrichment processes to maintain data integrity. Platforms with AI-driven automation and real-time updates can also enhance provider records, and reduce errors and discrepancies.

Data security and compliance

Security is critical when handling sensitive provider data. Consider LexisNexis alternatives that offer strong encryption, role-based access controls, and compliance with industry standards like HIPAA and GDPR. 

Evaluate the platform’s data breach prevention measures, audit logs, and incident response protocols as well. 

Regulatory compliance

Ensuring compliance with healthcare regulations is essential for provider data management software. Look for LexisNexis competitors that adhere to HIPAA, HITECH, and state-specific regulations. 

As well, consider platforms with comprehensive security frameworks, audit trails, and automated compliance monitoring to reduce risks. Platforms that support accurate credentialing and provider verification help maintain compliance while preventing fraud and billing errors.

Integration capabilities

Seamless integration with existing systems is crucial when evaluating LexisNexis alternatives. Ensure the platform is compatible with EHR/EMR systems, CRMs claims management tools, and other healthcare IT infrastructure. 

The software should also offer support for HL7, FHIR, and API-based interoperability to enhance data exchange.

Scalability and performance

Your chosen provider data management software should scale to accommodate growing data volumes and evolving business needs. For better results, consider LexisNexis competitors with cloud-based infrastructure. 

These offer better scalability and ensure high performance even with increasing user and provider records.

User experience and support

Software with a user-friendly interface and strong customer support improves platform adoption and efficiency. When considering LexisNexis alternatives, assess ease of use, customization options, and accessibility. 

Your software should include onboarding assistance, training materials, and responsive customer support via multiple channels, ensuring smooth implementation and ongoing success.

Streamline Provider Data Management with PRIME® by Atlas Systems

When choosing alternative software to LexisNexis for provider data management,  ensure it achieves the highest success rate in data accuracy.

That’s what PRIME® offers you. 

The software stands out as the best alternative provider data management software to LexisNexis for offering unmatched data accuracy and compliance. 

Unlike LexisNexis, which relies on aggregated data, PRIME® ensures real-time validation through direct provider outreach and AI-powered analytics, achieving a 95% success rate in accuracy. 

Our self-service portal simplifies data updates, while the AI-driven Ask PRIME® feature provides instant insights into your data. You can also ask any questions about your data and get instant answers. 

Our AI-powered dashboard enhances visibility, and FHIR compatibility ensures seamless integration. PRIME® streamlines provider data management like no other solution by reducing errors, minimizing provider abrasion, and ensuring compliance with CMS, CA SB137, and the No Surprises Act. 

Contact us today for a customized provider data management solution.

FAQs about LexisNexis Alternatives

1. What are the main reasons to consider LexisNexis alternatives for provider data management?

You may consider LexisNexis alternatives due to its high costs, concerns about data accuracy, limited customization, complex integration with existing systems, and compliance challenges. 

Furthermore, many LexisNexis competitors offer competitive pricing, real-time data updates, and more flexible workflows, making them suitable for organizations with specific needs.

2. How does PRIME® by Atlas Systems compare to LexisNexis?

PRIME® by Atlas Systems is a leading alternative to LexisNexis, offering real-time provider data validation, AI-driven analytics, and a self-service portal for easy data management. 

The software ensures 95% data accuracy, seamless integration with FHIR, and compliance with regulations like CMS and the No Surprises Act.

3. What factors should I consider when choosing a LexisNexis alternative?

When evaluating LexisNexis alternatives, consider data accuracy, security, compliance, integration capabilities, scalability, and user experience. 

Also look for solutions with real-time updates, strong encryption, regulatory adherence, seamless system integration, and user-friendly interfaces to ensure efficient provider data management tailored to your organization’s needs.