Provider match scores are produced by Verato's matching algorithm, which uses Verato Referential Matching® to compare incoming provider data against Verato's provider reference database and your existing provider identities. The same algorithm is used in two places:
- Search. When you search for a provider, each result is compared with your search criteria and receives a score based on how similar its attribute data is to your input.
- Record posting. When you add or update (post) a provider source record, the score helps determine whether that record matches an existing provider identity.
Match score scale
Match scores range from 0.0 to 1.0 and are displayed to three decimal places (for example, 0.857).
| Score | What it means |
|---|---|
0.0 | No similarity between the input and the provider identity record. |
Greater than 0.0 and less than 1.0 | Partial similarity. The higher the score, the more closely the input agrees with the provider identity record. |
1.0 | The highest level of similarity between the input and the provider identity record. |
What drives a provider match score
A match score is built from attribute clusters, which are groups of related attributes such as name, address, or license. Each cluster contributes to the score based on how well its values agree and how much weight it carries for that provider type. A strong match on a heavily weighted cluster moves the score more than a perfect match on a lightly weighted one.
Practitioners (Type 1)
Practitioner matching compares attributes that identify an individual clinician, such as name, National Provider Identifier (NPI), license, and address.
Health Facilities (Type 2)
Health facility matching is driven primarily by three attributes: organization name, NPI, and license number. Address contributes a smaller amount to the score. Phone number carries very little weight, so a matching phone number has almost no effect on a Health Facility match score.
In practice, a Health Facility match usually needs strong agreement on organization name, NPI, or license number. There is no minimum number of clusters that must agree. The decision is based on the overall weighted score.
How match scores drive matching decisions
Each add or update is evaluated against two thresholds that are configured for your instance.
| Score range | Typical result |
|---|---|
| At or above the Automatic Match threshold | The records are considered a definite match. Verato links them under a single LinkID. |
| Below the Automatic Match threshold and above the Manual Review threshold | The records are considered a potential match. Verato does not link them automatically and creates a data stewardship task so a data steward can decide. |
| Below the Manual Review threshold | The records are not considered a match and are not linked. |
Note: To review or change your instance's thresholds, contact Verato Support.
Reviewing a match score
When you review a provider stewardship task, open the Match Breakdown panel to see how the score was calculated. For each attribute cluster, the panel shows how strongly that cluster's data supported a match and how much it contributed to the score, out of the maximum it could contribute.
When you read the breakdown, keep these points in mind:
- The overall score determines whether records are linked, not any single cluster.
- A cluster with a small maximum contribution has little effect on the score, whether it matches or not.
- A low contribution from a lightly weighted cluster, such as phone number for a Health Facility, reflects how Verato weights that cluster. It does not indicate a data quality or ingestion problem.
Match override rules
If your instance uses match override rules, they are evaluated after standard matching. Override rules can adjust match scores, bonuses, or penalties based on your business rules, which can change the final match decision.
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