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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

STARSTrack serves as a cutting-edge analytics platform for healthcare quality, aimed at enhancing performance in various quality rating systems, including Medicare Stars, Marketplace Stars, local Medicaid programs, and Commercial quality rankings, by integrating data, analytics, and actionable insights into a single interface. It provides comprehensive visibility into all elements that impact quality performance through NCQA-certified quality measure calculations, accommodating HEDIS, Pharmacy Quality Alliance (PQA), CMS Operational, Medicaid Core Set, and customizable local measures, while also enabling proactive monitoring of future performance for analysts to concentrate on outcomes instead of tedious manual reporting. Furthermore, STARSTrack generates detailed built-in reports, consolidates star score intelligence across various contracts, and allows users to examine historical performance, current trends, and forecasted results, thereby facilitating strategic enhancement initiatives. By streamlining these processes, it ultimately empowers healthcare organizations to make informed decisions that lead to improved care quality.

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

Ingenia Health

Founded

2022

Country

United States

Website

ingeniahealth.com/solutions/starstrack/

Product Features

Product Features

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Alternatives

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