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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

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

SCT

Country

United States

Website

sctdemo.com

Product Features

Product Features

Alternatives

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