LexisNexis® Risk Solutions offers industry-leading identity management and payment integrity solutions for government healthcare programs.
By leveraging our extensive data, analytics and ability to link disparate data to over 700 million unique identities, we’re able to help federal agencies operate efficiently and prevent program fraud, waste and abuse.
LexisNexis Delivers
Accurate Provider Information
Our comprehensive, correct and current healthcare provider information is built from more than 10,000 data sources.
Data Provenance and Security
Unique identifiers provide a detailed, historical record of all data and its origins ensuring data quality.
Linking Technology
Disparate data sets housed in our secure High Performance Computing Cluster (HPCC) systems can be linked for additional insights.
Population Health Data
LexisNexis® Risk Solutions social determinants of health data goes beyond income and education to create understanding and opportunities to advance program success.
Remote Identity Proofing
Real-time, knowledge-based, multi-factor authentication confirms a patient’s or provider’s identity in seconds and protects sensitive information in health records.
Achieve These Results
Detect and Prevent Fraud
Verify that the right providers are paid for the appropriate services on eligible beneficiaries using data and advanced linking technology.
Understand Provider Relationships
Gain a 360-degree view into healthcare providers in your network and visualize relationships across IDNs, ACOs, payers and healthcare systems.
Unveil Large Fraud Schemes
See complex connections and unravel associated fraud schemes by linking activity between providers, payers and claimants through relationship mapping.
Share Information with Confidence
Resolve identities to a unique individual, allowing you to share health and benefit information across departments, agencies and alternate providers.
Detect Healthcare Fraud with Intelligent Investigator
LexisNexis Intelligent Investigator helps Special Investigations Units (SIUs) detect healthcare fraud to pinpoints suspicious behavior across all health care claim types.
Fight healthcare fraud with solutions that aggregate, analyze and link data to reveal suspicious, hidden connections between members, doctors and claims.
LexisNexis Intelligent Investigator helps a large healthcare payer with billing fraud detection to uncover hidden fraud patterns and overpayments to healthcare providers.
A Systematic Approach to Combat Healthcare Identity Fraud
Healthcare identity fraud impacts health plan enrollment, costing millions each year. A systematic approach to combat this type of fraud is critical for health plans.