Average Ratings 0 Ratings
Average Ratings 0 Ratings
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
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