When it comes to exclusion monitoring, there are a myriad of lists that need to be monitored, both at the federal and state levels to ensure that your patients are only seen by eligible providers. In this post, we will provide an overview of all healthcare exclusion sources and a few other eligibility-affecting databases.
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URAC accreditation for pharmacy benefit managers demonstrates a commitment to patient safety and transparency, but maintaining compliance.
Finding a healthcare exclusion in your organization can be stressful. Here's our OIG exclusion guidance for what to do next.
HCCA Compliance Institute 2021: Session with the OIG and Donna Thiel, Chief Compliance Officer at ProviderTrust
Donna Thiel, Chief Compliance Officer at ProviderTrust and two OIG officials, Nicole Caucci, Deputy Branch Chief and Joanna Francis, Reviewing Official, led a session on Understanding Exclusions at the virtual 2021 HCCA Annual Compliance Institute.
This Earth Day, we interviewed our very own Mary Moore. Mary is one of our resident Data Operations Analysts, a singer-songwriter, and dog-sitter. Among the many things she does, she also advocates for environmental awareness. We took the time to sit down with Mary to ask her what Earth Day means to her and how we […]
If you’re looking for an introduction or refresher of the HHS Office of Inspector General (OIG) Exclusion Program and the process of screening your population for exclusions, you’ve come to the right place. In this post, we explain the basics of OIG exclusions and exclusion list monitoring.
HHS OIG recently released another report about Medicare Advantage organizations including NPIs within encounter data and leveraging these identifiers for program integrity oversight.
We are excited to introduce our newest innovation! Instantly screen new providers for exclusions when they enter your workflow, then add them to ongoing exclusion monitoring for continued peace of mind.
What is OFAC? Should healthcare organizations search OFAC sources? In this post we provide an overview of OFAC SDN for healthcare.
Celebrating Our Partners Today, March 19th, is International Clients’ Day! On this day, ProviderTrust celebrates all of our clients who partner with us to make healthcare smarter and safer. The past year has been tough. From transitioning to remote work and adapting your policies and procedures, to battling physician burnout and taking care of the […]
OIG exclusion list monitoring is critical for healthcare organizations. But sometimes, excluded providers can go undetected for years. In this post, we explore how our data enrichment strategy caught a previously undetected exclusion that impressed the OIG enough for them to drop an investigation against our client.