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Ingenix Ongoing Sanctions Monitoring

Protect your plan from at risk providers and maintain this NCQA accreditation requirement. The Ingenix Ongoing Sanctions Monitoring service is a turn-key solution that will monitor your network for Medicare and Medicaid sanctions and state licensure sanctions. Enhance your risk management capabilities, reducing costs in the process.

Preventing harm. Steering you from danger. Keeping you safe.


Compliance

Ingenix Ongoing Sanctions Monitoring service is approved by the National Committee for Quality Assurance (NCQA). It offers a painless way for your plan to comply with rigorous requirements for continuous monitoring between credentialing cycles—which you need to be fully certified by NCQA.

Sanctions monitoring

  • Monitoring of Medicare/Medicaid sanctions
  • Monitoring of sanctions and limitations of licensure
  • Notification of new sanctions

Ongoing sanctions monitoring service

Ingenix Ongoing Sanctions Monitoring provides your health plans with a cost-effective, efficient solution to track sanctions, disciplinary actions, and limitations of licensure. We proactively notify you of any new or revised sanctioning incidents that meet the NCQA CR10 Standard for continuous sanctions monitoring.

Ingenix compiles your reports from the sanction data contained in the Ingenix Sanction Provider Datamart (SPD). SPD is comprised of sanctions collected from state boards across the country and the Office of the Inspector General (OIG) for Medicare and Medicaid Sanctions.

Due to the lack of provider data identifiers made available by the reporting sources, Ingenix has developed a matching process that is used to identify and link your network providers with the reported sanctions. This will help provide that no sanction goes unreported.

We generate your OSM Report and deliver it twice each month to ensure timely response and follow-up. Your reports will be formatted in Microsoft® Excel and delivered via secure email or FTP.

NCQA

The National Committee for Quality Assurance (NCQA) is an independent, not-for-profit organization dedicated to assessing and reporting on the quality of managed care plans, managed behavioral organizations, practitioner organizations and credentials verification organizations.

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