Exclusion screening for health plans and managed care
Monitor network providers, delegated entities, vendors and your own staff against federal and state exclusion lists every month, at the scale of a provider network.
Why exclusion screening matters here
- Medicaid managed care and Medicare Advantage plans are expected to keep people and organizations on exclusion lists out of their networks and administrative functions.
- Provider networks run to thousands of individuals and organizations across several states.
- Regulators and state agencies ask plans for evidence of monthly screening and of how each potential match was handled.
Who to monitor
- Network physicians and other providers
- Provider organizations and facilities
- Delegated and first-tier entities
- Employees, board members and vendors
How Exclia helps
Screening API and webhooks
Keep monitoring in step with your provider data system through the API.
Continuous exclusion monitoring
Screen individuals and organizations by NPI and name every month.
Potential match review
Work potential matches through one queue with a documented decision for each.
Source coverage and freshness
Show regulators exactly which federal and state lists were checked, and their versions.
Questions
Yes. Records can be loaded by CSV or managed through the API, and the Enterprise plan is quoted for large volumes.
Yes. Organizations are screened by legal name and NPI.
The coverage page lists every source screened today. Our exclusion lists directory describes every state list.
Related screening resources
See it on your own list
Start a free trial and screen your first records today, or run a free check on one name first.