Time Saving, Automated Sanctions Monitoring
Comprehensive and timely monitoring of healthcare provider sanctions is critically important. While the re-credentialing process takes place only every three years, the HHS Office of the Inspector General (OIG) issues new sanctions weekly.
Easier, more robust network credentialing is here. SanctionsTrack® is an automated, continuous sanctions monitoring solution from CAQH designed to seamlessly integrate with CAQH ProView® to enhance the value of your provider data.
- Automates the manual process of checking licensing boards, OPM and OIG, and matching for provider disciplinary actions.
- Reduces hours of staff time, eliminates redundant processes and improves results related to sanctions monitoring.
- Offers timely information to use in provider credentialing and evaluation decisions.
How SanctionsTrack and CAQH ProView Work Together
SanctionsTrack consolidates and electronically reports all provider sanctions and related license actions in the United States. It works in conjunction with CAQH ProView in the following way:
- Continuously queries more than 500 state licensing boards and other Federal sources for sanctions and disciplinary actions.
- Identifies providers with state licensing actions via centralized data collection.
- Uploads data to CAQH ProView nightly.
- Matches sanctions to individual providers in CAQH ProView.
- Automatically flags all sanctioned providers on your organization’s roster.
- Enables online searches and extract information on demand in several ways – by provider name, sanctions within a specific date range, or filtered by providers with a specific sanction type.
- Continuously queries more than 500 state licensing boards and other Federal sources for sanctions and disciplinary actions. The average time between a licensing board posting an action and CAQH reporting the event was 4.4 days.
- Identifies providers with multiple state licenses actions via centralized, weekly data collection. Find out early if a sanctioned provider is moving from state-to-state to set up practice.
- Includes reporting on providers who voluntarily "opt-out" of Medicare.
- Automatically flags all sanctioned providers on a participating organization’s roster.
- Helps meet the NCQA CVO Certification Option - for ongoing monitoring of practitioner sanctions between re-credentialing cycles.
Who uses SanctionsTrack?
Organizations that use CAQH ProView - health plans, hospitals and provider practices – can use SanctionsTrack for credentialing network providers, network claims validation, and fraud and abuse detection programs.
Contact your CAQH account manager to schedule a consultation and demonstration.