Change from:   What Do Payers Do with Clinical Information? Payers require clinical data from providers who order or provide services. They use this data to document prior authorization, process and audit claims, and to confirm medical necessity and appropriateness. Clinical data is used by Payers to create risk profiles for members for value-based care contracts and population health adjustments. Quality reporting requirements and quality care scoring all require clinical data for evaluating clinical performance and outcomes. Payers also want to create a clinical record of their members to improve care coordination and provide optimum medical care. For example with this information they can reduce redundant care, shift to more proactive and timely care, and make better informed and more accurate medical treatment and care planning recommendations. Payers may use this clinical record to give providers information that may assist in care coordination.   to:   What Do Payers Do with Clinical Information? Payers require clinical data from providers who order or provide services. They use this data to document prior authorization, process and audit claims, and to confirm medical necessity and appropriateness. Clinical data is used by Payers to create risk profiles for members for value-based care contracts and population health adjustments. Quality reporting requirements and quality care scoring all require clinical data for evaluating clinical performance and outcomes. Payers also want to create a clinical record of their members to be able to reduce redundant care and make better medical treatment and care planning recommendations to providers.