Network Management
Keep patients in-network, track every referral from creation to closure, and prevent the out-of-network leakage that silently drains your shared-savings performance.
The Challenge
Every time a patient is referred to an out-of-network specialist, your organization loses visibility, continuity, and shared-savings dollars. Referrals disappear — no follow-up confirmation, no results returned, no closed loop. High-cost out-of-network utilization quietly drains your VBC performance without triggering any alert until the reconciliation check fails to arrive.
Five Core Capabilities
AI continuously monitors referral patterns and flags out-of-network utilization — alerting care teams before high-cost encounters occur and recommending preferred in-network alternatives.
Every referral tracked from creation to completion — automatically following up on pending consults, capturing results, and ensuring no referral falls through the cracks.
Scores every specialist and facility in your network by cost, quality, outcomes, and patient satisfaction — surfacing top performers and flagging high-cost outliers.
Full visibility into referral volumes, specialty distribution, cost per episode, and utilization trends — enabling data-driven decisions about network composition and care pathways.
AI recommends highest-value in-network providers at the point of referral — reducing out-of-network costs and protecting shared-savings performance before the episode occurs.
Specialties Covered
ROI: 10-Provider Clinic
| Metric | Before Unity | After Unity |
|---|---|---|
| In-Network Rate | 76% | 94% ↑ |
| Referral Visibility | Minimal | 360° ↑ |
| OON Cost Exposure | $340K/yr | $120K ↓ |
| Referral Closure Rate | 41% | 87% ↑ |
Explore Other Modules
All eight modules share the same AI engine, patient data, and action pipeline.
Stop leakage before it
costs you a check.
We'll show you the exact out-of-network exposure in your current referral patterns.
Built for HIPAA · Aligned with SOC 2-type controls · FHIR R4 Ready · ROI in 90 Days