An Interactive Guide to Data Enrichment
From the beginning, we set out to create healthcare compliance monitoring technology that delivered better results and required less manual work than any other solution.
We quickly realized that meant we would need to build a proprietary data set that was smarter and more complete than any publicly available sources. So we did. Here’s what that means.
OIG and State Exclusions
The primary source data for OIG and State Medicaid exclusions has significant gaps. These sources are missing key information that would make it easy to identify whether an individual or entity in your population is a match to an exclusion record.
We’ve enriched primary source exclusion data to empower smarter, more accurate exclusion matches within any population. This enriched data sets a high bar for the ProviderTrust Standard of Certainty.
Primary Source Data vs. ProviderTrust
NPI at the Primary Source
NPI numbers are powerful data points for identifying exclusions among providers. For NPI-holding populations, we can return powerful insights into exclusions and more.
NPI
SSN, EIN, TIN
Additional Data
Data Enrichment Confirms Exclusions Other Solutions Miss
Without data enrichment, you’re left trying to rule out exclusion matches based on very little information.
Just how little? Check out a few of these real exclusion records we found.
What does data enrichment mean for ProviderTrust clients?
of the exclusions we return we found with augmented data
We return zero potential matches back to your team
Complete peace of mind and time back in your team's day
Explore the Interactive Exclusion Monitoring Solution Guide.
The ProviderTrust Standard of Certainty
Other exclusion monitoring services match exclusions based on unreliable data, such as a name. We match based on unique identifiers, giving you complete confidence that every exclusion match is fully verified and 100% accurate.
Unique Identifiers
NPI Number
SSN, EIN, TIN
License Number
Alaska
Georgia
Alabama
?%
How good is our data? Good enough to get the OIG to drop an investigation.
Read More
Learn More
Exclusions that ProviderTrust has an NPI for.
25,944
18,417
Exclusions that have an NPI at the primary source.
SSN, EIN, TIN at the Primary Source
Many LEIE and State Medicaid exclusions are for people or entities that are not assigned an NPI. For these records, we’ve added other uniquely identifying data points, ie. SSN, EIN, and TIN.
196,200
Exclusions that we have added a SSN, EIN, or TIN to.
243
Exclusions have an SSN, EIN, or TIN at the primary source.
Additional Data Enrichment
We’ve enriched more than 91% of all exclusion records, empowering immediate exact matches. That other 9%? We use human experts to investigate matches in your population, delivering complete confidence every time.
91%
Exclusions that ProviderTrust has any enriched data points for.
9%
Exclusions that we manually verify for 100% accuracy.
We back up our results with a $10M E&O policy
Data enrichment saves our clients time by removing the manual elements of checking for exclusions and investigating potential matches. The larger your monitored populations, the more significant impact on your teams’ workload.
What is the total number of current healthcare related exclusions?
221,746
As of May 2022