Accurate, Ongoing Compliance Monitoring for Provider Networks
Eliminate compliance risk across your organization with a solution fueled by data that’s even better than the primary source.
The Industry’s Most Definitive Results
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People & Entities Monitored Ongoing
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Exclusions Discovered by ProviderTrust
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Exclusions Found Only With Our Enhanced Primary Source Data
Up-to-Date Provider Eligibility Status
Our HITRUST- and NCQA-certified solution consolidates monitoring processes across par and non-par provider networks and empowers your compliance team with full oversight and audit-ready documentation.
Our proprietary data strategy uses unique identifiers to make our data even better than the primary source, providing exact-match results only with unbeatable accuracy.
Who We Monitor:
- Participating and Non-Participating Provider Networks
- Employees
- Vendors
- First-Tier, Downstream, and Related Entities (FDRs)
- Members
Fully Automated For Continuous Coverage
Ongoing compliance checks for your provider networks
Automated compliance monitoring removes tedious, error-prone manual work from your plate and ensures that you’re alerted to a change as soon as it appears on the primary source. We’ll never miss a primary source update, so neither will you.
Monitoring for all federal and state exclusion/sanction lists
Our primary sources include:
- HHS-OIG and GSA-SAM.gov
- All State Medicaid Exclusion/Sanction Lists
- CMS Preclusion List
- NPPES NPI Registry
- Medicare Opt Out
- SSN Death Master File
- OFAC SDN and Non-SDN List
- State Licensing Boards
- Specialty Boards
- DEA and/or CDS
NPDB *enterprise clients only
Best-in-Class Data
Exact-match results only
Our solution fills in the gaps of incomplete primary source data, providing exact-match results only. Unlike other low-cost vendors who return partial results, we eliminate the need for your team to investigate “potential matches,” saving you valuable time and resources.
Stay audit-ready with detailed reporting
We automatically capture and store all of the information you need to be ready for an audit or survey at any time. Plus, you’ll have complete oversight of your results with in-depth reports available whenever you need them.
Organization-Wide Compliance Visibility
Ongoing monitoring for your entire population
Monitor your employee population for federal and state exclusions, just the same as you monitor your provider network, leaving no stone unturned with risk around exclusion and sanction screening.
Gold-standard vendor data collection and monitoring
Even with regulatory controls in place, fraud, waste, and abuse in healthcare persist. Prioritize vendor data collection and ongoing exclusion monitoring for your FDRs and high-risk vendors to ensure compliance for your Medicare Advantage LOB.
Data Integrity Built to Scale
Explore our monitoring and verification solutions, especially designed for Compliance teams.
Provider Credentialing
Speed up turnaround times by 97% and ensure the accuracy of your results with ProviderTrust’s HITRUST- and NCQA-certified primary source verifications.
How an Enterprise Payer Partnered with ProviderTrust for a Compliance Overhaul
Partnering with ProviderTrust allowed the client to automate their exclusion monitoring and primary source verification processes fully.
