LexisNexis Provider Integrity Scan vs. HIPAA ComplyPAK

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.

The cloud-based Compliance Management System, known as HIPAA ComplyPAK™, has shown to be an effective tool for clients aiming to successfully navigate audits. It provides tailored, comprehensive guidance for each role handling Protected Health Information (PHI), ensuring that all operations align with HIPAA regulations. The system comprehensively addresses critical needs regarding Privacy, Security, and Group Health Plans, while also allowing for ongoing monitoring of compliance status through regular auditing processes. Additionally, it empowers Privacy Officers to actively manage the compliance efforts of their teams. Users benefit from generating compliance status reports on demand, along with easy access to relevant policies and procedures specific to their roles for quick reference and action. It also aids in identifying potential risks related to noncompliance and delivers effective tools for risk management and mitigation strategies. Furthermore, the platform supports the implementation of Healthcare Modules that include pre-established policies and procedures, enhancing overall operational efficiency. HIPAA ComplyPAK™ ensures adherence to the legal requirements outlined by HIPAA and HITECH by effectively tracking Protected Health Information. It also provides convenient, on-demand online training for staff, including certification options, to ensure employees are knowledgeable about compliance practices. This comprehensive approach not only streamlines compliance efforts but also fosters a culture of accountability and continuous learning among staff members, ultimately contributing to better organizational health and compliance outcomes.