Eliminate Fraud, Waste and Abuse with Provider Intelligence

Eradicate repeat offenders and speed up FWA investigations by leveraging real-time compliance intelligence, designed especially to capture full provider profiles that complement the needs of a modern Special Investigations Unit.

Provider Intelligence to Power Your Investigations

Instant compliance intelligence on every provider with only an NPI

Know the full profile of every par and non-par provider instantly with only an NPI, creating simplicity from complexity and saving your team valuable time.

Maintain an up-to-date directory of par and non-par providers

Set business rules based on claims thresholds and workflow design to better define and manage your par and non-par populations, all in one monitoring platform.

Automated Intelligence with Human Governance

Ongoing, continuous compliance monitoring

From the moment we turn on monitoring, we continuously screen your provider networks to ensure we reduce your risk. Say goodbye to manual searches and point-in-time checks.

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. Access your provider insights in your system of record through our seamless and secure API integrations.

Reduce Overpayment and Wasteful Spending

Overpaying claims and trying to recoup later is inefficient

Between $68 and $226 billion is lost annually to Fraud, Waste and Abuse (FWA). With provider network monitoring that is both continuous and always accurate, you can spot claims from ineligible providers before they are paid.

Claims recovery efforts are costly

Traditional methods of claims recovery can quickly escalate the cost of the claim. Our primary source data monitoring and matching algorithms help payment integrity teams spot potential FWA faster and support your SIU teams with the documentation they need to build their cases.

View All Case Studies

"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.'"