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Average Ratings 0 Ratings

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ease
features
design
support

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Write a Review

Description

To mitigate potential risks, the Centers for Medicare and Medicaid Services (CMS) have instituted guidelines to ensure the validation of their networks. Given that Pharmacy Benefit Managers (PBMs) are significantly impacted by the risk assessment process, the demand for precise and actionable insights has reached unprecedented levels. The LexisNexis Provider Integrity Scan streamlines a variety of provider verification processes and offers continuous monitoring by cross-referencing numerous files and lists, while also delivering automatic alerts for numerous high-risk factors. This tool is proficient in screening and verifying providers both before and after enrollment, aiming to uncover and thwart criminal activities effectively. By identifying potentially fraudulent providers and businesses involved in health-related programs, the LexisNexis Provider Integrity Scan serves to lower costs for health care payers and PBMs alike. Our innovative solution empowers users to effectively conduct multiple searches and access crucial information, enhancing their operational efficiency and security. This comprehensive approach not only safeguards the integrity of health care programs but also fosters a more reliable health care environment.

Description

Optimize your enrollment procedures by utilizing our comprehensive, mobile-first enrollment solution, which is designed to eliminate paper transactions and enable the collection of member information seamlessly. Enhance your entire workflow, from enrollment to reconciliation and service delivery, minimizing errors and the necessity for manual tasks. Gain a consolidated view of your assigned leads, outstanding items, alerts, and notifications for better oversight. Benefit from intelligent prospecting features, including the ability to schedule tasks, conduct follow-ups, and efficiently manage lead assignments and searches. Experience remote and offline processing for applications and enrollments, allowing for immediate access to vital information that improves turnaround times. Ensure compliance with Centers for Medicare and Medicaid guidelines by capturing scopes of appointment effectively. Leverage dynamic mobile forms that facilitate the on-the-go collection of enrollees’ details and signatures, making the entire enrollment process more agile and responsive. This solution empowers organizations to stay ahead in a fast-paced environment, ensuring efficiency and accuracy in member management.

API Access

Has API

API Access

Has API

Screenshots View All

Screenshots View All

Integrations

XML

Integrations

XML

Pricing Details

No price information available.
Free Trial
Free Version

Pricing Details

No price information available.
Free Trial
Free Version

Deployment

Web-Based
On-Premises
iPhone App
iPad App
Android App
Windows
Mac
Linux
Chromebook

Deployment

Web-Based
On-Premises
iPhone App
iPad App
Android App
Windows
Mac
Linux
Chromebook

Customer Support

Business Hours
Live Rep (24/7)
Online Support

Customer Support

Business Hours
Live Rep (24/7)
Online Support

Types of Training

Training Docs
Webinars
Live Training (Online)
In Person

Types of Training

Training Docs
Webinars
Live Training (Online)
In Person

Vendor Details

Company Name

LexisNexis

Founded

1970

Country

United States

Website

risk.lexisnexis.com/products/provider-integrity-scan

Vendor Details

Company Name

Newgen Software

Founded

1992

Country

United States

Website

newgensoft.com/solutions/industries/healthcare-payer/medicare-enrollment/

Product Features

Product Features

Electronic Medical Records (EMR)

Appointment Management
Charting
Compliance Tracking
E-Prescribing
E/M Coding
HIPAA Compliant
Handwriting Recognition
Integrated Telehealth
MIPS Certified
Meaningful Use Certified
ONC-ATCB Certified
Patient Portal
Self Service Portal
Voice Recognition

Alternatives

Alternatives

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