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We deliver smarter provider and pharmacy network monitoring.

We find provider and pharmacy network inaccuracies and fraud you can’t, ensuring continuous eligibility and generating cost savings for your health plan or PBM

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What can continuous provider and pharmacy eligibility monitoring do for you?

Our smarter approach to eligibility monitoring delivers always-accurate data insights about the people and entities in your networks. 

Ensure continuous compliance with network eligibility requirements

We offer a holistic model that delivers complete provider profiles with always-accurate statuses and audit-ready historical reporting. Customize your eligibility requirements based on your organization’s specific needs. Get ongoing insight into OIG and State Medicaid Exclusions, primary source license and certification verification, NPI status, Medicare Opt-Out, DEA, FDA Debarment, and more. 

Stop ineligible claims before they’re paid

Protect revenue and reduce recoupment efforts in your government LOBs. Our Smarter Data and more frequent primary source verifications allow us to find compliance and eligibility issues at the first sign of a problem. These faster and smarter alerts empower your organization to stop ineligible claims in their tracks.

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Reduce FWA in your provider and pharmacy networks

The bad actors in healthcare are often sophisticated at flying under the radar of fraud detection. Our proprietary technology is designed to catch ineligible providers even when they’re hiding behind changed names or billing as entities. Leverage holistic eligibility monitoring within your FWA workflows to detect fraudulent providers earlier. 

Reduce administrative complexity across teams

As healthcare evolves, interoperability and secure data exchanges are increasingly important.  Our plug-and-play solution integrates seamlessly with your existing tools and workflows. Customize and deliver alerts across your organization, while maintaining a single source of truth for your network data. And already verified matches means your teams don’t lose time confirming verifications.

What makes ProviderTrust different?

Our enhanced, proprietary data engine is what sets us apart and makes us smarter than the primary source. Smarter data allows our technology to catch more eligibility issues than any other solution, for both par and non-par populations. In fact, 30-40% of the exclusions we find in provider networks are discovered only with our enhanced data.  

See a Case Study About Smarter Monitoring

Meet Dash, the smarter monitoring solution for payers and PBMs.

Dash is the customizable, ongoing compliance monitoring solution for your entire provider or pharmacy network.

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Say Hello to Dash

Improve provider data accuracy
Stop Fraudulent Claims
Spot FWA faster by connecting your monitoring results to claims management software.
Flexible Integrations
Put insights and alerts where you need them with API and SSO integrations.
Instant Results
Run an ad hoc screen and easily move that provider to ongoing monitoring.
Automated exclusions monitoring
Custom Requirements
Customize your monitoring requirements and notifications by line of business or geography.

Find out what makes us different.

Want to learn more about how you can empower smarter healthcare? Get started.

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ProviderTrust | Our Story