Get better intelligence about your provider networks.
Ensure every provider meets credential and eligibility requirements for your government LOBs.
So much more than just OIG Exclusions.
Get better intelligence into your provider networks. Combine our industry-leading OIG and Medicaid exclusions with license monitoring, NPI validation, DEA registration, CMS ordering and referring, Medicare Opt Out, Social Security Death Master, and more. Customize these requirements by network participation.
Get instant insight and long-term confidence.
Say goodbye to manual investigations and verifications. Screen one or more providers for exclusion, license, NPI issues (and more) and then add them to your ongoing monitoring population. With instant insight and audit-ready historical reporting, you can be confident that your providers are properly credentialed and have peace of mind without ever having to look up a license board.
Reduce compliance risk and identify fraud faster through enriched data.
We enrich both primary source data with identifiers to catch and verify issues no one else can, alerting you to issues within your provider network that you would never otherwise find. Meet audit and survey requirements with the click of a button.
Deliver actionable provider network intelligence across your organization.
Improve critical processes and break down data silos. Smarter, always-accurate provider network data that’s easily accessible through our software, or your system of record. Our flexible integrations empower your teams to make more informed decisions, faster.
The Provider Network Monitoring Solution Guide
It’s time to rethink some of the old processes for managing provider networks. Find out what’s included in holistic provider network monitoring and how it can make your job easier.
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Rely on our smarter data to fill in the gaps and complete your provider records.
Resources to help Provider Operations teams grow & succeed.
Health Equity, Interoperability, and Affordability: Highlights from the 2021 BlueCross BlueShield National Summit
In a nine-day virtual conference, the 2021 BlueCross BlueShied Summit featured focus on health equity, interoperability, and affordability.
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Provider directories and the data that power them must evolve to meet the needs of both changing regulatory requirements and an increasingly digital member base.