uncover-hidden-provider-risks-spectrum-analysis
Uncover Hidden Provider Risks with LexisNexis® Spectrum Analysis
In today’s complex healthcare landscape, identifying provider risk early is essential for protecting patients, preserving public funds, and safeguarding program integrity.
LexisNexis® Spectrum Analysis for Providers uses advanced referential data, linking technology, and LexisNexis® Risk Solutions Special Investigation Unit (SIU) expertise to surface deeper indicators of risk and reveal non-obvious relationships that traditional checks can miss.
Provider fraud is becoming increasingly complex, and agencies need deeper, more than surface-level compliance checks. Spectrum Analysis for Providers helps agencies view providers as dynamic individuals with evolving identities, relationships, and risk signals—so teams can prioritize investigations, reduce improper payments, and minimize administrative burden for honest practitioners.
Powered by 10,000+ referential public and proprietary sources and industry-leading linking technology, this analysis can help uncover risk signals and relationships that may otherwise go undetected.
Spot non-obvious provider risks
Identify deeper risk indicators such as:
- Undisclosed sanctions
- Expired licenses
- Criminal records
- Financial distress and other risk factors that can threaten care quality and program sustainability
Go beyond one-to-one checks by linking disparate data to unique identities, helping you uncover:
- Connections to excluded individuals
- Potential shell companies
- Networks with histories of fraud or collusion patterns
Strengthen provider screening, verification and monitoring to take proactive action before fraud occurs—identifying high-risk actors earlier, protecting patient safety, and safeguarding taxpayer dollars. Because inaccurate or outdated provider records can lead to improper payments, duplicate billing and phantom providers, Spectrum Analysis for Providers improves confidence in provider identity and affiliation data to support stronger payment integrity and more effective detection of fraud, waste, and abuse.
Download the tip sheet
Get the LexisNexis® Spectrum Analysis for Providers tip sheet to see how data-driven insights can help your agency uncover hidden risks, detect suspicious networks, and strengthen proactive monitoring.
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