Average Ratings 0 Ratings
Average Ratings 0 Ratings
Description
Centauri Health Solutions is a company specializing in healthcare technology and services, motivated by our commitment to enhance the efficiency of the healthcare system for our clients while offering compassionate assistance to those in need. Our software, powered by advanced analytics, supports hospitals and health plans—including Medicare, Medicaid, Exchange, and Commercial sectors—in effectively managing their fluctuating revenue through a bespoke workflow platform. Moreover, our personalized support for patients and members grants them access to vital benefits that can significantly improve their quality of life. Our array of solutions encompasses Risk Adjustment (including Medical Record Retrieval, Medical Record Coding, Analytics, and RAPS/EDPS Submissions), management of HEDIS® and Stars Quality Programs, Clinical Data Exchange, Eligibility and Enrollment services, Out-of-State Medicaid Account Management, Revenue Cycle Analytics, and both Referral Management & Analytics, as well as addressing Social Determinants of Health to further bolster healthcare outcomes and accessibility. Each of these components is designed to work in harmony, ultimately creating a more effective and compassionate healthcare experience for everyone involved.
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.
API Access
Has API
No
API Access
Has API
No
Integrations
XML
No
Pricing Details
No price information available.
Free Trial
No
Free Version
No
Pricing Details
No price information available.
Free Trial
No
Free Version
No
Deployment
Web-Based
Yes
On-Premises
No
iPhone App
No
iPad App
No
Android App
No
Windows
No
Mac
No
Linux
No
Chromebook
No
Deployment
Web-Based
Yes
On-Premises
No
iPhone App
No
iPad App
No
Android App
No
Windows
No
Mac
No
Linux
No
Chromebook
No
Customer Support
Business Hours
Yes
Live Rep (24/7)
No
Online Support
No
Customer Support
Business Hours
Yes
Live Rep (24/7)
No
Online Support
Yes
Types of Training
Training Docs
Yes
Webinars
Yes
Live Training (Online)
Yes
In Person
Yes
Types of Training
Training Docs
Yes
Webinars
Yes
Live Training (Online)
Yes
In Person
Yes
Vendor Details
Company Name
Centauri Health Solutions
Founded
2014
Country
United States
Website
www.centaurihs.com
Vendor Details
Company Name
LexisNexis
Founded
1970
Country
United States
Website
risk.lexisnexis.com/products/provider-integrity-scan
Product Features
Medical Billing
Claims Processing
No
Claims Scrubbing
No
Code & Charge Entry
No
Compliance Tracking
Yes
Customizable Dashboard
Yes
Dunning Management
Yes
Invoice History
Yes
Patient Eligibility Checks
No
Practice Management
No
Quotes/Estimates
Yes
Remittance Advice
Yes
Revenue Cycle Management
Accounts Receivable
No
Claims Management
No
Collections Management
No
EHR/EMR Integration
No
For Healthcare
No
ICD-10 Compliance
No
Insurance Verification
No
Medical Billing
No
Patient Portal
No
Patient Registration
No
Patient Scheduling
No
Payment Processing
No