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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
LexisNexis WorldCompliance Data provides a widely recognized suite of comprehensive sanctions and high-risk entity information, designed to enhance the efficiency of batch screening for customers, suppliers, and third parties. This resource features customizable, modular access to essential watchlist screening and due diligence information, which includes global sanctions and enforcement lists such as those from OFAC, EU, UN, and HMT, as well as data on Politically Exposed Persons (PEPs) and their relatives, adverse media profiles sourced from over 30,000 feeds, state-owned enterprises, links to sanctions ownership, and official government registration lists, with continuous updates of new profiles. Organizations benefit from the ability to customize risk categories across more than 60 specific segments, aligning with their individualized risk management strategies, ultimately enhancing screening efficiency, reducing the occurrence of false positives, and minimizing potentially expensive compliance risks. The solution can be integrated effortlessly through APIs into platforms like Bridger Insight XG, Firco Compliance Link, or Firco Trust, and it also offers the option to be hosted offline within secure private networks. Additionally, the platform is designed to adapt to evolving regulatory landscapes, ensuring that users remain compliant with the latest requirements.
API Access
Has API
API Access
Has API
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
LexisNexis
Founded
1970
Country
United States
Website
risk.lexisnexis.com/products/worldcompliance-data
Product Features
Product Features
AML
Behavioral Analytics
Case Management
Compliance Reporting
Identity Verification
Investigation Management
PEP Screening
Risk Assessment
SARs
Transaction Monitoring
Watch List