Resource Library

Insight and advice from the experts.

Viewing Exclusions Resources

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Blog

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 […]

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 […]

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 […]

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 […]

Case Studies

How University Health Prevented Impending Fraud in One Day

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Case Studies

Strengthening Home Health Fraud Prevention

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Case Studies

ProviderTrust Helps DCI Scale Expanding Compliance Monitoring Needs

For more than a decade, ProviderTrust and Dialysis Clinic, Incorporated (DCI) have cultivated a partnership dedicated to effective employee compliance monitoring that helps ensure safe healthcare for DCI’s clients.

Blog

Keeping Fraud, Waste, and Abuse Out of Home Health Care

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.