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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

PDSpectrum is an advanced online policy processing software that allows users to handle various tasks including sales, billing, claims, and finance management. Its functionalities encompass a wide range of features such as accounting, claims processing, rating, underwriting, administration, and document management, among others. Accessible through a secure web browser, PDSpectrum ensures user safety while utilizing its platform. Additionally, it offers comprehensive data connections and integration capabilities with partners like LexisNexis and InsVista, enhancing its utility and reach in the industry. This robust system is designed to streamline operations and improve efficiency for its users.

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 Yes 
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) Yes 
In Person Yes 

Vendor Details

Company Name

LexisNexis

Founded

1970

Country

United States

Website

risk.lexisnexis.com/products/provider-integrity-scan

Vendor Details

Company Name

Priority Data

Founded

1979

Country

United States

Website

prioritydata.com

Product Features

Product Features

Insurance Policy

Cancellation Tracking Yes 
Claims Tracking Yes 
Policy Generation Yes 
Policy Issuance Yes 
Policy Processing Yes 
Quotes / Estimates Yes 
Rating Engine Yes 
Reinstatement Tracking Yes 
Reinsurance Administration Yes 
Renewal Management Yes 
Underwriting Management Yes 

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