Accurate, Ongoing Compliance Monitoring for Provider Networks

Eliminate compliance risk across your organization with a solution fueled by data that’s even better than the primary source.

The Industry’s Most Definitive Results

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People & Entities Monitored Ongoing

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Exclusions Discovered by ProviderTrust

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Exclusions Found Only With Our Enhanced Primary Source Data

Up-to-Date Provider Eligibility Status

Our HITRUST- and NCQA-certified solution consolidates monitoring processes across par and non-par provider networks and empowers your compliance team with full oversight and audit-ready documentation.

Our proprietary data strategy uses unique identifiers to make our data even better than the primary source, providing exact-match results only with unbeatable accuracy.

Who We Monitor:

Fully Automated For Continuous Coverage

Ongoing compliance checks for your provider networks

Automated compliance monitoring removes tedious, error-prone manual work from your plate and ensures that you’re alerted to a change as soon as it appears on the primary source. We’ll never miss a primary source update, so neither will you.

Monitoring for all federal and state exclusion/sanction lists

Our primary sources include:

HHS-OIG and GSA-SAM.gov
All State Medicaid Exclusion/Sanction Lists
CMS Preclusion List
NPPES NPI Registry
Medicare Opt Out

SSN Death Master File
OFAC SDN and Non-SDN List
State Licensing Boards
Specialty Boards
DEA and/or CDS
NPDB *enterprise clients only

Best-in-Class Data

Exact-match results only

Our solution fills in the gaps of incomplete primary source data, providing exact-match results only. Unlike other low-cost vendors who return partial results, we eliminate the need for your team to investigate “potential matches,” saving you valuable time and resources.

Stay audit-ready with detailed reporting

We automatically capture and store all of the information you need to be ready for an audit or survey at any time. Plus, you’ll have complete oversight of your results with in-depth reports available whenever you need them.

Organization-Wide Compliance Visibility

Ongoing monitoring for your entire population

Monitor your employee population for federal and state exclusions, just the same as you monitor your provider network, leaving no stone unturned with risk around exclusion and sanction screening.

Gold-standard vendor data collection and monitoring

Even with regulatory controls in place, fraud, waste, and abuse in healthcare persist. Prioritize vendor data collection and ongoing exclusion monitoring for your FDRs and high-risk vendors to ensure compliance for your Medicare Advantage LOB.

Meet DynamicNPI™

Access Verified, Connected Primary Source Data with Just an NPI

DynamicNPI is the payer industry’s most comprehensive source of verified provider data, connecting disparate primary source information directly to NPI numbers.

Meet credentialing and recredentialing verification requirements in mere seconds
Speed up time to credential, expediting the path to revenue
24/7 access to up-to-date, verified information
Hands-off NCQA-certified automation you can trust
Delivered directly within your workflow of choice with ProviderTrust’s turnkey API

View All Case Studies

“With ProviderTrust, we’ve reduced so much manual work that it has freed up time for our team to focus on additional compliance initiatives that, historically, we just didn’t have enough resources to address. We didn’t have to add staff to get the compliance oversight we always needed.”

Data Integrity Built to Scale

Explore our monitoring and verification solutions, especially designed for Compliance teams.

Provider Credentialing

Speed up turnaround times by 97% and ensure the accuracy of your results with ProviderTrust’s HITRUST- and NCQA-certified primary source verifications.

How an Enterprise Payer Partnered with ProviderTrust for a Compliance Overhaul

Partnering with ProviderTrust allowed the client to automate their exclusion monitoring and primary source verification processes fully.

Related Resources

Case Studies