Tracking & verifying licenses is easier than ever with ProviderTrust
Primary source verification
When a license is uploaded to the ProviderTrust system it will be verified at the primary source (state licensing or certifying boards) for each healthcare discipline. Actively track and manage licenses that are up for renewal and receive documentation directly from the primary source.
Expiring license notifications
You’ll get an email when a healthcare license you are managing is about to expire, and if it lapses. Customize these notifications to a schedule that works for your team to make sure you never have an employee working on the floor with an expired license.
Track impaired licenses
Keep track of impaired licenses to identify employees or providers who need their licenses updated in good standing. Impaired licenses may include probation, restriction, and more.
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How does ProviderTrust license verification work?
Three easy steps to protect your organization.
1. When a license is entered into the system, it will be verified at the primary source.
2. As the license is approaching expiration, it is verified at least ten days prior to the expiration date. If not renewed, we will send daily updates up to five days past due, and then changes to a monthly schedule, and finally a quarterly verification.
3. You’ll be able to monitor the license for sanctions across all 50 states and over 2,500+ sources (disciplinary actions, license board orders, meeting minutes, etc.). If a sanction is found that could impact the license, the license will be re-verified to ensure that it is still active and in good standing, and you will be notified.
Automate your exclusion checks today
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“Never once since we implemented the ProviderTrust system have we had any issues with a provider treating a patient without the proper certifications or license or with an expired license; or have we had anyone working for us that has been sanctioned.”
License verification 101
Everything you want to know about verifying and tracking licenses with ProviderTrust. Have a question that’s not listed? No worries, contact us here.
Why monitor licenses?
There are several reasons to conduct monthly license and/or certification monitoring. First, state licensing boards require that a provider be qualified to conduct or perform services requiring a license. The same is true for a certification that is treated as a license (ie., AART). In order to lawfully comply and provide services, the provider must be in good standing with the state license board. Otherwise, the employer can be liable for providing unlicensed care or care from a nonlicensed provider.
Second, remaining in good standing is required by most federal healthcare programs such as Medicare and Medicaid by contract with CMS. If the person is required to be licensed, but is not, the employer may face a False Claims Action and have to reimburse the payor, plus pay fines to the government.
Third, a license and/or certification will expire upon one of two triggering events: (1) its expiring term and/or (2) a revocation or termination.
Finally, if an individual is sanctioned or disciplined, an employer should be aware of this to prevent the individual from practicing outside the scope of their license. This could result in penalties or sanctions for the organization.
Certifications can be treated as a license in some cases if they are issued by a state agency in lieu of a license or from a recognized association that regulates a profession.
So in order to remain continually compliant, an employer should monitor the status of a license and/or certification on an ongoing basis.
How can I avoid license fraud at my organization?
Look out for some of these red flags from the provider or employee:
- Failure to provide the license
- Provides copied and/or altered license
- Look for non-uniform text, cut and paste lines, or a non-standard expiration date
- Demonstration of competencies inconsistent with licensure
- Inconsistent state of licensure information
Can I verify licenses myself?
The state licensing board is deemed the “primary source” to verify and monitor for license renewal, license standing, and in some cases, disciplinary actions taken against the individual and/or the license.
There are more than 80 different types of professional healthcare licenses – with job titles ranging from a Medical Assistant to a Board Certified Brain Surgeon. Some state licensing boards have a different database for each type of license.
Considering the 50 different states and numerous types of licenses, there are thousands of possible primary sources that may need to be cross-referenced to verify one single license.
Why risk missing a license when ProviderTrust can do all the heavy data lifting for you?