Stop Pay-and-Chase with Proactive, Frontend Eligibility Checks
Eliminate ineligible claims and reduce overpayment, proactively stopping payments to bad actors before they head out your door.
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.'"
Reimagine Your Claims Editing Process, Identifying Bad Actors Pre-payment
Ineligible claims are more than a setback. They directly impact your organization’s bottom line. We partner with you to catch exclusions and invalid licenses pre-payment — providing continuous, always-accurate network eligibility insights to halt faulty claims before they process.
Reduce Overpayment and Wasteful Spending
Overpaying claims and trying to recoup later is inefficient
Claims recovery efforts are costly
Ensure Compliance in a Shifting Regulatory Environment
Maintain an up-to-date directory of eligible providers
Defend the integrity of your government LOBs
With monitoring that is both smarter and faster, you can catch exclusions and other issues hiding in your provider network among par and non-par providers alike.
Simplify Administrative Complexities and Workflows
Adjust your claims editing process to include eligibility pre-checks
Why wait until post-payment to identify provider network eligibility? Our always-accurate intelligence provides simplified insights about your provider network, empowering your team to remove bad actors before the claims editing process even begins.
Connect your system of record via seamless and secure integrations
Speed to action is critical for pre-payment screening. We’ve designed our provider network monitoring to deliver fully verified eligibility alerts weeks (or months) before any other solution. Access your provider insights in your system of record through our seamless and secure API integrations.
Thoughtfully Curated for Your Organization
One powerful monitoring and verification platform, designed with Payment Integrity in mind.
Provider Network Monitoring
Innovated for intelligence. Handcrafted for humans.
Ensure SOC II and NCQA-certified security standards and controls.
Primary Source Verification
Verify every license and credential for all providers directly at the primary source.
Reporting and Documentation
Always be audit-ready with primary source documentation for every provider.