Optimize your Value-Based Network with Centralized Data
Ensure your members are being cared for by the right practitioner at the right time by using one centralized monitoring solution to strengthen your provider networks.
Go Beyond Good Enough
Leverage enriched data to reduce risk and quickly identify fraud
There’s value in peace of mind. We enrich primary source data with unique identifiers to catch and verify issues no one else can. With more 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
Maintain an up-to-date directory of eligible providers
With continuous monitoring of eligibility requirements, your team can spot provider ineligibility among your network in real-time, providing critical insights for both your par and non-par provider directories.
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.
A Comprehensive Monitoring and Verification Infrastructure
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 for your credentialing teams.
Primary source credential verifications built to scale
Our NCQA-accredited continuous compliance monitoring and primary source verification ensure that every provider has the required credentials to serve your members.
"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.'"
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Data Accuracy and Integrity Built to Scale
Explore our monitoring and verification solutions, specially designed with the integrity of your provider network in mind.
Provider Network Monitoring
We deliver healthcare’s most comprehensive compliance intelligence platform for provider eligibility and continuous compliance.
License and Credential Verifications
Our NCQA-accredited automated primary source verifications and ongoing license and credential monitoring ensure that every provider has the required credentials to serve your patients.
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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Related Resources
Blog
Provider Credentialing: What Payers Need to Know
Licenses and Credentials
Payers
April 14, 2023
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Guides
Provider Network Monitoring Guide
Licenses and Credentials
Payers
Providers
August 10, 2022
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Guides
License and Credential Verification Solution Guide
Exclusions
Licenses and Credentials
Payers
January 01, 2022
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