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When “Excluded” Doesn’t Mean Gone: Exclusion Evasion in a $4.75M Medicare Case

Exclusion from Medicare and Medicaid is meant to be a hard stop — no billing federal programs, no working in a billing-connected role, and no […]

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ProviderTrust Earns 3-Year NCQA Credentialing Certification

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The Industry Keeps Announcing “The First” Shared Credentialing Program

By Christopher Redhage, Co-Founder and Managing Partner, ProviderTrust The industry loves throwing this launch party. This is the second one in about thirteen months with […]

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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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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 […]

Can Excluded Physicians Refer, Order or Prescribe? Featured Image

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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

SFTP vs API : Which Integration Method Is Best? Featured Image

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The Credentialing Data Gap: Why Payer Teams Are Still Chasing Data Manually

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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How to Conduct an Effective Healthcare Compliance Audit

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

Blog

Why ProviderTrust Is Launching an AI Trust & Integrity Program — and Why It Matters to Your Team

The truth is that daily verification just doesn’t move the needle as much as some of our competitors claim. It’s time to retire the idea of daily verification as the answer to the complex problem of license verification, and we’re here to explain why.