Automate continuous monitoring of your provider network across Federal and State Exclusion Lists (OIG LEIE, SAM/GSA, all available state lists), NPPES (for NPI registry and verification), State Sanction Lists, and all Healthcare Licensing Boards.
Seamlessly integrate ProviderTrust directly into your claims processing system using our API, enabling an instant screen of every claim to ensure accuracy, compliance, and eligibility.
Combines continuous network monitoring with instant screens allowing for real-time status checks on every provider on every claim. This helps SIU teams greatly reduce the amount of claims needing to be recovered due to reimbursement to excluded providers, sanctioned or unlicensed providers, or providers on any Opt Out list (i.e., Medicare Opt Out List).
Our advanced data science process can be leveraged to enhance your provider directory to ensure accuracy and compliance, from ensuring an NPI is active and valid to monitoring for exclusions to verifying licensure per billing requirements.
Read more about how we helped one of the country’s top health plans catch an average of 28 excluded providers per week, allowing them to recover funds that were previously inadvertently paid out.
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