Population-health intelligence for Medicare Advantage, built by someone who has run the plan you run.
Vernier covers the payer, the provider, the member, the agent, credentialing, risk adjustment and the CMS interoperability mandate. Not a dashboard layer: eight deployed applications, demonstrable on screen, designed by an operator who has stood up five Medicare Advantage plans and five ACOs.
Everything a risk-bearing organization needs to see, in one contract.
Vernier is read-and-decide across the whole plan. It ingests your adjudicated claims feed, surfaces the exception and the owner, and leaves the transaction in the core system you already own. No competitor covers analytics, care and utilization management, and plan operations in one platform.
Analytics Portal
Fourteen modules: Patient 360, coding suspects, RAPS triage, Star Ratings, MLR, utilization, membership and churn, claims, encounter submission, member materials, premium billing.
Explore analytics → CMS-0057-FInteroperability
Patient Access, Provider Access, Payer-to-Payer and Prior Authorization APIs on FHIR R4, with the seven-day decision clock carried on every request.
Explore the FHIR APIs → Plan operationsAdmin Portal
Enrollment lifecycle, agent approval, scope-of-appointment compliance, authorizations, correspondence, workflow and a data-health layer that keeps every queue in view.
Explore admin → NetworkProvider Portal
Eligibility, prior authorization, a claims worklist with denial resolution, remittances, and evidence-backed coding and care-gap worklists, scoped to the practice's own panel.
Explore provider → MemberMember Portal
Coverage, ID card, claims, prescriptions and labs with plain-language explanations in English and Spanish, guided appeals, secure messaging and a consent center.
Explore member → OutreachCRM
One activity log for calls, notes, tasks, email and physical mail, with document upload and six standard reports.
Explore CRM → NCQACredentialing
Practitioner and facility credentialing on a guarded state machine with an immutable audit trail and automated primary-source verification.
Explore credentialing → AssessmentVernier HRA
Adaptive health risk assessment with fourteen condition modules, validated screener escalation, nurse review and sign-off, and a living document per member.
Explore HRA →Five Medicare Advantage plans. Five ACOs. Thirty-five years.
Bruce Romanello designed, launched and ran five CMS-approved Medicare Advantage plans across Florida, South Carolina and Georgia, established one of the nation's first Shared Savings ACOs in 2011 and four more after it, and owned one of the largest Humana-affiliated MSOs in Florida.
Vernier is the platform he kept asking vendors to build: one that keeps every queue measured, says what is not built, and puts the number where it cannot be walked past.
The demo most vendors cannot give.
Every Vernier application shares one set of members, providers, claims and identifiers. In a demo, one member is followed through four products and the numbers agree at every step. Most competitors show one screen per product with unrelated fixture data.
Member Portal
The member signs in, sees coverage, the ID card, claims and prescriptions, and a denial explained in plain language.
Provider Portal
The same member appears on the practice's attributed panel with the same claims, coding suspects and open care gaps.
Analytics Portal
The plan sees the member in Patient 360, the risk-adjustment view, the Star measures and the claims detail that sums to the header.
FHIR API
A Patient Access request returns the same person as FHIR resources, with provenance marking every record as claims-derived.
The demo population is deterministic: the same seed produces the same numbers in front of every prospect, and an automated suite checks that header totals equal the sum of their detail rows, that every coding suspect cites a record that exists, and that every NPI passes the check digit.
The deadline has a date and an owner.
Four FHIR APIs in production
Patient Access, Provider Access, Payer-to-Payer and Prior Authorization. Vernier implements all four against FHIR R4, US Core 6.1.0, CARIN Blue Button 2.0 and Da Vinci PDex and PAS, with 42 automated conformance assertions passing.
Standard prior-auth decisions move from 14 days to 7
The half of the rule that reorganizes a utilization-management department. Vernier shows the queue of authorizations that will breach the clock this week, and who owns each one.
Your prior-authorization numbers become public
The rule requires annual posting of prior-authorization statistics. Vernier publishes the disclosure from the same data the queue runs on, so you know what the numbers say before anyone else does.
Every AI feature has a rules path that always runs.
Vernier's AI rewrites output. It does not make determinations. Every explanation, triage and draft is computed first by deterministic rules from the member's own records. A language model, when configured, rewrites the prose and nothing else. No AI call runs on a page render, so the platform is fully functional, and fully demonstrable, with no model key at all.
- Coverage decisions, agent rejections and eligibility denials require a human action.
- Member-facing AI is scoped to the authenticated member's record by construction.
- Every AI suggestion and the human action taken on it is logged.
Value-based, at-risk organizations.
Startup and small MA plans
2,000 to 25,000 members. The whole stack, at a price shaped for a plan that cannot afford an enterprise vendor.
PACE organizations
Small census, high touch. Care management, HRA and outreach, with the FHIR mandate that does not apply to you left off the pitch.
IPAs, MSOs and ACOs
The provider portal, risk adjustment and population analytics for organizations that own attribution and feel provider abrasion directly.
TPAs and administrators
One relationship, several plans. Analytics and portals your clients log into, on top of the core system you run.
Twenty minutes. No deck.
Bring your current system list. Bruce will open the applications, trace one member across them, and show you what January 1, 2027 looks like when it is handled.