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What is LexisNexis Provider Integrity Scan?

In order to address potential risks, the Centers for Medicare and Medicaid Services (CMS) have established guidelines aimed at validating their networks. The significant influence of risk assessment processes on Pharmacy Benefit Managers (PBMs) has led to an unprecedented demand for accurate and actionable insights. The LexisNexis Provider Integrity Scan simplifies a variety of provider verification tasks and maintains continuous oversight by cross-referencing a multitude of files and lists, while additionally providing automatic notifications for various high-risk indicators. This tool excels in screening and validating providers both prior to and after enrollment, effectively working to detect and prevent criminal activities in the sector. By identifying potentially fraudulent providers and entities associated with health programs, the LexisNexis Provider Integrity Scan contributes to cost reduction for health care payers and PBMs. Furthermore, our cutting-edge solution enables users to perform multiple searches and access vital information, thereby improving their operational efficiency and security. This comprehensive strategy not only protects the integrity of health care programs but also cultivates a more trustworthy healthcare landscape, ultimately benefiting patients and providers alike.

What is ClearRoster?

ClearRoster is a web-based application tailored for small healthcare practices to facilitate exclusion screenings and record management. Users have the option to either enter the names of staff and vendors individually or upload a spreadsheet, while ClearRoster conducts monthly verifications against the federal OIG List of Excluded Individuals/Entities, SAM.gov exclusions, and 15 state Medicaid exclusion or termination lists. The system not only provides close name matches but also details the matching methodology and guides users to the publisher’s search for additional verification of any potential matches. In addition, ClearRoster keeps a comprehensive and dated log of the monthly screenings, which includes the specific sources that were checked, their last updated dates, the names that were screened, and the results of these evaluations, all of which can be downloaded for future reference. Users should be aware that having similar names does not necessarily indicate exclusion, thus they are required to carefully assess any potential matches. The service is limited to the designated states and is specifically designed as a screening and recordkeeping tool, without providing any legal or compliance advice. Furthermore, ClearRoster strives to ease the process for healthcare practices, ensuring they remain aware of any exclusions that may affect their operations, which ultimately supports their commitment to providing quality care. By utilizing this tool, healthcare professionals can better manage their compliance risks while focusing on patient service.

Media

Media

No images available

Integrations Supported

XML

Integrations Supported

API Availability

API Availability

Pricing Information

Pricing not provided

Pricing Information

$29/month, 14-day free trial
14-day free trial; $29/month for up to 100 people and vendors, or $49/month for up to 500. No card needed to start.
Free Trial Offered?

Supported Platforms

SaaS

Supported Platforms

SaaS

Customer Service / Support

Standard Support
Web-Based Support

Customer Service / Support

Not specified

Training Options

Documentation Hub
Webinars
Online Training
On-Site Training

Training Options

Not specified

Company Facts

Organization Name

LexisNexis

Date Founded

1970

Company Location

United States

Company Website

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

Company Facts

Organization Name

Neverclosed

Company Website

clearroster.tryneverclosed.com/

Categories and Features

Healthcare Compliance

Not specified

Categories and Features

Healthcare Compliance

Not specified

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