How To: Understand Instant Search Result Types

Summary

This article outlines the availability and functionality of ProviderTrust instant searches, which differ based on the contracted monitoring services. Searches may be conducted using NPI, name, or SSN, and will return results related to exclusions, sanctions, NPI validation, Medicare opt-out status, SSDMF, and the CMS Preclusion List. Please note that access to the CMS Preclusion List requires a Delegation Agreement and is not included in the standard Exclusion Monitoring package.

Overview

The availability of instant searches within ProviderTrust depends on the monitoring services contracted by your organization. Instant searches are accessible directly through the ProviderTrust user interface (UI) and allow rapid verification across multiple federal and state data sources.

Available Instant Search Sources

ProviderTrust provides instant search access to the following sources:

• Federal & State Exclusions

• Office of Foreign Assets Control (OFAC)

  • Specially Designated Nationals List - SDN

  • Consolidated Sanctions List - Non-SDN Lists)

• CMS Medicare Opt-Out

• NPI Validation (National Plan & Provider Enumeration System - NPPES)

• Social Security Death Master File (SSDMF)

• CMS Preclusion List*
  *The CMS Preclusion List is not included in the Exclusion Monitoring package. It is an additional product requiring a Delegation Agreement from the ProviderTrust client, as well as the CMS Preclusion List itself.

   

Performing an Instant Search

By NPI

An NPI-based search will return exact matches for:

• NPI validation
• Federal & State Exclusions (aka Sanctions)
• Medicare Opt-Out
• CMS Preclusion List*
  *As noted above, the CMS Preclusion List requires a Delegation Agreement

By Individual Name 

A search using a first and last name will return potential matches for:

• Federal Exclusions & State Exclusions (aka Sanctions)
• OFAC

By Organization Name

A search using a business name will return potential matches for:

• Federal Exclusions
• State Sanctions (aka State Exclusions)
• OFAC

By SSN

An SSN-based search will return exact matches for:

• SSDMF (Social Security Deathmaster File)

Please note: Searches by SSN do not return any potential or matched exclusions