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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 Health e(fx)?

The employer mandate outlined in the ACA is complex, placing an uneven burden on HR benefits teams responsible for compliance with its regulations. Moreover, the existence of individual mandates at the state level complicates the already intricate environment of employer health reform, which is subject to ongoing changes. Health e(fx) simplifies ACA reporting by offering customized services and innovative solutions tailored to address a variety of requirements. Our commitment to client support is fundamental to our mission and identity. This unwavering dedication is a key reason why our software is relied upon by 75 companies listed among the Fortune 500. Leveraging our vast experience in health reform, Health e(fx) has positioned itself as the premier technology solution for the Affordable Care Act (ACA), currently supporting over 22.5 million individuals. As the pandemic continues and staffing challenges endure, along with the rise of a pro-ACA administration, employers face increasing difficulties in navigating ACA and state mandate reporting, along with the benefits, payroll, and tax professionals who assist them. In light of these ongoing shifts, Health e(fx) remains agile and forward-thinking, ensuring that we can effectively adapt to the changing needs of our clients while providing exceptional service throughout the process. Our goal is to empower organizations to thrive in this evolving regulatory landscape.

Media

Media

Integrations Supported

XML

Integrations Supported

XML

API Availability

Has API

API Availability

Has API

Pricing Information

Pricing not provided.
Free Trial Offered?
Free Version

Pricing Information

Pricing not provided.
Free Trial Offered?
Free Version

Supported Platforms

SaaS
Android
iPhone
iPad
Windows
Mac
On-Prem
Chromebook
Linux

Supported Platforms

SaaS
Android
iPhone
iPad
Windows
Mac
On-Prem
Chromebook
Linux

Customer Service / Support

Standard Support
24 Hour Support
Web-Based Support

Customer Service / Support

Standard Support
24 Hour Support
Web-Based Support

Training Options

Documentation Hub
Webinars
Online Training
On-Site Training

Training Options

Documentation Hub
Webinars
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

HealthCare Impact Associates

Company Location

United States

Company Website

healthefx.us

Categories and Features

Categories and Features

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