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Research Reports

Provider Network Integrity: A Data Intelligence Report

Provider directories matter because members rely on them. When a health plan member searches for an in-network doctor, they’re trusting that the listing is current, […]
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Case Studies

How Highmark Found Undetected Healthcare Exclusions in Month One

Healthcare exclusion monitoring is not a back-office formality, especially for Highmark, one of the largest Blue Cross Blue Shield licensees in the country. It is […]
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Blog

Highlights from the OIG Spring 2026 Semiannual Report to Congress

The U.S. Department of Health and Human Services Office of Inspector General (HHS-OIG) has released its Spring 2026 Semiannual Report to Congress, summarizing its oversight […]
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Research Reports

The Dynamics of Provider Eligibility Data Management

How healthcare executives manage provider eligibility data — and what needs to change. Provider eligibility data serves a critical role across the administrative and operational […]
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Published, Not Perfect: What's Lurking in Your Provider Directory? Featured Image Events

Published, Not Perfect: What’s Lurking in Your Provider Directory?

Health plans are legally required to publish their provider networks via a FHIR-based API — a public statement of who is credentialed, in good standing, […]
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What 150 Healthcare Executives Really Think About Provider Eligibility Data Featured Image Blog

What 150 Healthcare Executives Really Think About Provider Eligibility Data

Provider eligibility data touches nearly every corner of a healthcare organization. It underpins some of the most consequential decisions an organization makes — from hiring […]
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ProviderTrust and Madaket Health Form Strategic Partnership to Enhance Provider Data Accuracy across Healthcare Featured Image News

ProviderTrust Celebrates 16 Years of Keeping Healthcare Safe

From a 2010 dream to monitoring 14 million individuals, the Nashville-based healthcare tech leader marks 16 years of growth by continuing to eliminate fraud, waste, […]
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How University Health Prevented Impending Fraud in One Day Featured Image Case Studies

How University Health Prevented Impending Fraud in One Day

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A Race Against Time: Why Timely MFCU Reporting Is Vital to Medicaid Program Integrity Featured Image Blog

A Race Against Time: Why Timely MFCU Reporting Is Vital to Medicaid Program Integrity

Do you have the resources; time and or people? Do you have the expertise? Do you have an internal audit team or are you using contract auditors?

How often should you audit? What do you do with the audit findings? I am tired already, and we haven’t even gotten started.

*Updated from original post on 11/15/2016

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