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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 Consensus Signal?

Consensus Signal provides real-time alerts for health-related events, ensuring that healthcare providers and care teams remain interconnected regardless of the treatment location of patients. By partnering with Secure Exchange Solutions, a leading provider of event notification services, we broaden our reach within electronic health records (EHRs) and offer access to a detailed national directory that simplifies the process of finding the right healthcare provider for each patient. This collaboration enables us to integrate alerts directly into the workflows of healthcare providers’ EHR systems without incurring high costs associated with interface implementations. Furthermore, there is no obligation to upload patient lists or even have an EHR, as we can efficiently send user-friendly alerts to existing email systems. The recent introduction of new Conditions of Participation (CoPs) mandates compliance for hospitals involved with Medicare and Medicaid, including psychiatric hospitals and Critical Access Hospitals (CAHs), which must now electronically inform primary care providers about patient admissions, discharges, or transfers. Consequently, this system not only facilitates better communication but also significantly improves patient care coordination across different healthcare environments, ultimately leading to enhanced health outcomes. This innovative approach reflects a commitment to advancing healthcare technology and ensuring that critical information is readily accessible to those who need it most.

Media

Media

Integrations Supported

XML

Integrations Supported

API Availability

API Availability

Pricing Information

Pricing not provided

Pricing Information

Pricing not provided

Supported Platforms

SaaS

Supported Platforms

SaaS

Customer Service / Support

Standard Support
Web-Based Support

Customer Service / Support

Standard Support
Web-Based Support

Training Options

Documentation Hub
Webinars
Online Training
On-Site Training

Training Options

Online Training
On-Site Training

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

Consensus Cloud Solutions

Company Location

United States

Company Website

www.consensus.com/signal/

Categories and Features

Healthcare Compliance

Not specified

Categories and Features

Healthcare Compliance

Not specified

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