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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
Effectively tailor and oversee Policies and Procedures (PnPs) while enabling electronic searches for PnPs and agency standards. Users can attach relevant notes and documents to their respective agency standards, ensuring comprehensive documentation. Additionally, facility documents can be prepared and managed ahead of Surveys. End-users will have the capability to electronically search their agency standards and will be able to view or link insights, notes, related operational documents, and PnPs. They can utilize name or keyword search functions to find standards, operational documents, and PnPs efficiently. Moreover, end-users can prepare for agency surveys with guided tools that assist in navigating PnPs, amendments, and tracking deficiencies. There is also an option to create log-ins specifically for consultant roles and oversight. With HOTB’s innovative technology, policies and procedures can be automatically generated based on specific data inputs from the end-user’s agency, ensuring a tailored approach to compliance and performance monitoring. This dynamic customization empowers agencies to stay compliant while enhancing their operational efficiency.
API Access
Has API
API Access
Has API
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
SCT
Country
United States
Website
sctdemo.com