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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
Medisolv offers a wide range of quality management solutions tailored for healthcare providers, including hospitals and clinicians. Our flagship platform, ENCOR, stands out as an award-winning, all-encompassing quality solution designed to streamline operations. As a dedicated healthcare quality data management firm, Medisolv equips organizations with a comprehensive Quality management software that simplifies core measure abstraction and facilitates electronic measure capture across both hospital and outpatient settings. This software enables effective data aggregation from diverse sources and ensures seamless submission to various reporting entities, such as CMS, TJC, state agencies, payers, and organizations like ACOs. With ENCOR, healthcare facilities gain access to up-to-date eCQM performance data, empowering them to enhance their outcomes while simplifying compliance with regulatory programs. Additionally, ENCOR enhances the chart abstraction process by providing daily updated data and automatically pre-filling patient information, making it easier for hospitals to fulfill their reporting obligations efficiently. Ultimately, our software is crafted to support healthcare institutions in navigating the complexities of quality reporting and achieving their performance goals more effectively.
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
Medisolv
Founded
1999
Country
United States
Website
medisolv.com
Product Features
Product Features
Hospital Management
Accounting Integration
Appointment Management
Appointment Scheduling
Bed Management
Billing & Invoicing
Claims Management
In-Patient Management
Inventory Management
Medical Billing
Out-Patient Management
Patient Records Management
Physician Management
Policy Management
Revenue Management