Audience
Businesses searching for a solution to reduce risk and prevent fraud
About LexisNexis Provider Integrity Scan
To prevent the risk, Centers for Medicare and Medicaid Services (CMS) has established requirements to validate their networks. As Pharmacy Benefit Managers (PBMs) bear the brunt of this risk assessment, the need for accurate, actionable information has never been greater. LexisNexis Provider Integrity Scan automates a variety of provider verification searches and ongoing monitoring options by checking against multiple files and lists and provides automatic red flag alerts for a wide range of high-risk indicators. It has the capability of screening and verifying pre-enrollment as well as monitoring post-enrollment to detect and prevent criminal activity. LexisNexis Provider Integrity Scan is designed to help reduce health care payers' and PBM's costs by identifying potentially fraudulent providers and businesses enrolled or attempting to enroll in health-related programs. Our solution gives users the ability to efficiently process multiple searches and obtain critical information.
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