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Smarter monitoring for your provider network.

ProviderTrust helps health plans maintain the integrity of their provider network.

Instead of chasing down money paid on fraudulent claims, what if you could keep it from being paid out in the first place?

Our tools integrate with your workflow to fill in the gaps of your provider data, keeping you compliant and keeping money from leaving your pocket to pay fraudulent claims.

License Monitoring

Simplify ongoing monitoring across your entire provider network

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.

License Monitoring

Instantly screen each and every claim - before payment

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.

License Monitoring

Significantly Reduce the Costs of Claims Recoupment

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).

Ensure Accuracy

Ensure Provider Directory Accuracy

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.

The proof is in the results

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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Get results like these for your organization

Why wait? Take the next steps to making your job easier, more efficient, and better than ever. Get in touch to demo our software, get pricing, or just introduce yourself.

Leah-CircleIf you'd rather just give us a call, you can reach us at:

(615) 938-7878