ProvCheck streamlines provider screening, credentialing, and enrollment to support state Medicaid programs with an automated, efficient, and compliant verification solution.
Get Started Request DemoOur provider verification system is designed to support and advance key Medicaid program objectives.
Ensure only qualified providers serve Medicaid members, supporting better health outcomes for members and the State as a whole.
Ensure budget predictability through shared risk and accountability with a reliable provider base.
Support access to care, quality measures, and member satisfaction by efficiently processing qualified providers.
Create efficient and cost-effective administrative systems and structures through automation and standardization.
Support a sustainable delivery system that is Provider-led and operated and managed by Providers to the maximum extent possible.
Our reusable provider verification system automates the provider screening, credentialing, and enrollment process with powerful features.
Advanced capabilities to link individuals to their organizations, match multiple name variations, and cross-check data elements against authoritative sources for consistency.
Retain screening and enrollment information, create watch lists for potential fraud, track re-enrollment attempts, and re-screen periodically to ensure profile accuracy.
Establish a graded screening methodology that escalates the intensity of screening for providers flagged as higher risk with advanced report card methodology.
Persist data source scores to determine reliability, evaluate data sources for accuracy, and create a learning system to flag suspicious enrollments early in the screening process.
Find specific provider information quickly, identify applicants including individual providers and owners of institutional providers, and verify identity and prior history.
Reduce manual elements and automate the entire provider screening process from start to finish with efficient tracking and documentation.
Built for HIPAA security and Section 508 accessibility, with a MITA-aligned design that supports the MITA 7 Conditions and Standards — evidence-ready for state SMC and funding conversations.
Build a multi-state, multi-program provider screening application capable of risk scoring, credentialing validation, and identity authentication.
Integrates with existing MMIS and security systems to provide a seamless experience across all platforms and services.
A smooth transition to ProvCheck with minimal disruption to your state's operations
We analyze your current workflow, needs, and goals to create a customized implementation plan for your state's Medicaid program.
Our team configures ProvCheck to match your program's unique requirements, from templates to workflow rules and business processes.
We securely connect ProvCheck with your existing systems and data sources with accuracy verification at every step.
Comprehensive training sessions ensure your team is comfortable and proficient with all system features and processes.
Our implementation specialists provide on-site and remote support during the critical transition period to ensure continuity.
We continuously work with you to optimize the system based on real-world usage, evolving needs, and regulatory changes.
See what our clients have to say about ProvCheck
Schedule a personalized demo today and see how ProvCheck can streamline your Medicaid provider screening and enrollment processes.