Maintain Network Compliance and Instantly Detect Fraud, Waste, & Abuse
Eliminate human error in manual federal and state exclusion checks through automated, always-accurate provider data.
We Catch and Verify Exclusions No One Else Can
Leverage enriched data to reduce risk and quickly identify fraud
Our enriched primary source data enables instant verifications for Par and Non-Par networks using limited provider data. With robust intelligence at your fingertips, your teams can meet and exceed audit and survey requirements with the click of a button.
Get complete intelligence on your provider networks
Combine our industry-leading instant license verifications with our OIG, SAM.gov, state Medicaid exclusion monitoring, NPI validation, DEA registration, CMS ordering and referring, Medicare Opt Out, Social Security Death Master File, and more. Customize those requirements by network participation.
Ensure Compliance in a Shifting Regulatory Environment
Receive ongoing alerts to provider non-compliance
Ongoing alerts to provider non-compliance with government LOBs are delivered into existing workflows.
Fines and penalties create a devastating effect on your organization
Civil fines and penalties can be assessed by the OIG with more than $20,000 per each item claimed or services provided. Avoid fines and penalties altogether through more comprehensive monitoring.
Consolidate and Centralize Exclusion Monitoring
The new standard in compliance intelligence
Consolidated processes across your provider network, workforce, and vendor populations reduce spend and provide readily-available reporting for CMS, URAC, NCQA, and internal audits.
Connect your system of record via seamless and secure integrations
We’ve designed our provider network monitoring to deliver fully verified eligibility alerts weeks (or months) before any other solution. Get your provider insights in your system of record through our seamless and secure API integrations.
"In a short period of time, ProviderTrust’s guidance and expertise has simplified our day-to-day operations and improved our overall business, but more importantly, it’s allowed us to focus on achieving our mission ‘To Improve the Oral Health of All.'"
Data Accuracy and Integrity Built to Scale
Explore our monitoring and verification solutions, specially designed with Compliance and Payers in mind.
Provider Network Monitoring
We deliver healthcare’s most comprehensive compliance intelligence platform for provider eligibility and continuous compliance.
OIG Exclusion List Monitoring
We deliver healthcare’s most trusted ongoing OIG LEIE, SAM.gov, and state Medicaid exclusion list monitoring.
Go beyond regulatory requirements with ease.
Data Security
Ensure SOC II and NCQA-certified security standards and controls.
Network Accuracy
Prioritize patient safety and access beyond initial credentialing.
Reporting and Documentation
Always be audit-ready with primary source documentation for every provider.
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