Authenticate a Healthcare Provider’s Identity and Eligibility in Real-time
Health Market Science offers solutions to authenticate the personal and professional identity of healthcare providers as well as their eligibility prior to submitting a claim, enrolling in an HIE or government program, or giving a provider access to Personal Healthcare Information (PHI). Leveraging the data from the Health Market Science Provider MasterFile™, Provider Eligibility will validate a prescriber’s license and credentials prior to determining eligibility or granting access to PHI.
The Health Market Science Provider Eligibility solution enables you to:
- Proactively check initial provider enrollments
- Pre-populate Health Information Exchange (HIE) provider directories with comprehensive provider profiles including professional identifiers, demographics, affiliations, and sanctions
- Access licensed provider profiles by region, state or nationally
- Authenticate provider professional identities
- Review randomly posed questions about providers automatically generated from the Provider MasterFile profiles after web service requests
- Verify provider professional credentials
- Perform a national web service checks of provider’s licenses, DEA statuses, and sanctions at the time of a PHIrequests
- Support compliance with each CMS Call Letter
- Provide real-time prescriber privilege checks without jeopardizing customer satisfaction
- Measure your exposure to risk
- Control how prescriptions get processed across pharmacy stores
- Manage compliance vigilance across millions of claims per day
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