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Average Ratings 0 Ratings

Total
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

PDSpectrum is an advanced online policy processing software that allows users to handle various tasks including sales, billing, claims, and finance management. Its functionalities encompass a wide range of features such as accounting, claims processing, rating, underwriting, administration, and document management, among others. Accessible through a secure web browser, PDSpectrum ensures user safety while utilizing its platform. Additionally, it offers comprehensive data connections and integration capabilities with partners like LexisNexis and InsVista, enhancing its utility and reach in the industry. This robust system is designed to streamline operations and improve efficiency for its users.

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

Priority Data

Founded

1979

Country

United States

Website

prioritydata.com

Product Features

Product Features

Insurance Policy

Cancellation Tracking
Claims Tracking
Policy Generation
Policy Issuance
Policy Processing
Quotes / Estimates
Rating Engine
Reinstatement Tracking
Reinsurance Administration
Renewal Management
Underwriting Management

Alternatives

Alternatives

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