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Average Ratings 0 Ratings

Total
ease
features
design
support

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Write a Review

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® Trail Tracker™ provides investigators with the ability to strategize for each case, outline necessary actions, document their findings, set reminders, and oversee records. This tool enhances workflows through features like monitoring case statuses, tracking referral tips, assigning claims to relevant departments for assessment, delegating cases to investigators, and managing their workloads efficiently. Additionally, Trail Tracker™ serves as a valuable asset for Special Investigations Unit (SIU) management, facilitating the measurement of investigator performance on various cases, tracking recoveries and savings, and generating reports on the activities of the unit. By consolidating all pertinent information into a single system, it promotes greater efficiency and consistency throughout the investigative process. This comprehensive approach not only streamlines operations but also empowers teams to collaborate more effectively.

API Access

Has API No 

API Access

Has API No 

Screenshots View All

Screenshots View All

Integrations

XML Yes 

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 Yes 

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) No 
In Person No 

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/trail-tracker

Product Features

Product Features

Investigation Management

Contact Management No 
Data Management No 
Incident Management No 
Reporting & Statistics No 
Subject Profiles No 

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