SOLUTIONS

Know Your Provider – Monitoring

KYP Monitoring completely automates the monthly monitoring requirements as mandated by ACA 6028. Not only it automates the mandatory checks against exclusion lists and license boards but it also provides additional checks against federal, state and local criminal records and sanctions.
KYP - Monitoring

Brings unparalleled provider vigilance capabilities to table, to keep a tab on potential fraud

  • Delivers compliance with ACA requirement for monthly verification against LEIE and SAM exclusion lists
  • Minimizes risk by continuously checking status of other important provider attributes
  • Enhances user efficiency by up to 90% through automation
  • Delivers tangible Return on Investment (ROI) through fraud prevention (identifying 2 – 3 times more ineligible providers)

Key Capabilities

  • Alert Generation Automates periodic checking of providers and related parties per ACA and generates alerts for exceptions
  • Alert Types Classifies alerts into various categories and watch lists and provides complete details for review
  • Research and Investigation Built-in research tools for validating monitoring results and recording observations
  • Resolutions Take one or more actions on providers like suspend or terminate account, generate letters for provider etc
  • Configurable Workflow Automates workflows for review of monitoring actions while providing flexibility required by knowledge workers
  • Reports Includes canned reports on summary and detailed metrics related to monitoring alerts and user actions