AML solutions for Healthcare

FinScan provides a suite of solutions to protect healthcare organizations from fines and reputational damage.

The challenge

Healthcare organizations, including providers, health and life insurance carriers, pharmacies, and those receiving funds from Medicare and Medicaid, are required to maintain a compliance program that protects patients and prevents financial fraud. Screening against the OIG’s LEIE list, state lists, and others ensures that you don’t hire or contract with any individual or entity that is excluded from receiving reimbursements from Medicare or Medicaid. Failure to do so may result in serious fines, damage to your organization’s reputation and most importantly, harm to you patients.

Your compliance program must also protect against other types of financial fraud, including money laundering, scams, terrorist financing and more. Here too, identifying and screening of individuals and entities is crucial in protecting against enforcement actions, financial loss, and bad press. FinScan helps keep you compliant, with the added benefits of improving the patient experience and growing your business.

Compliance

  • Screen against all lists required by Medicare and Medicaid, including OIG LEIE and GSA EPLS
  • Screen against any available state-level exclusion lists for the highest accuracy possible
  • Screen against sanctions, watchlists, politically exposed person (PEP), and adverse media lists
  • Create and screen against your own customized lists 
  • Identify ultimate beneficial owners (UBO) within complex ownership and control structures

Data Quality

  • Improve data quality and standardize data for more efficient screening and analysis
  • Avoid missd hits that result from poor data quality
  • Ensure consistent and structured data feeds from various source systems
  • Create a single source of truth where records are accurate and up-to-date
  • Provide patients and customers with a streamlined digital experience

Operational

  • Perform real-time screening of persons, entities, and transactions for ongoing protection
  • Get real-time ID validation to speed onboarding without sacrificing compliance
  • Reduce false positives to decrease time and resources spent on reviewing inaccurate matches
  • Automate screening processes over time and utilize constant monitoring
  • Integrate screening and compliance processes within your internal systems

Regulatory

  • Comply with Medicare and Medicaid exclusion list regulations 
  • Comply with AML sanctions screening regulations
  • Use standardized compliance reports across operations
  • Create and manage custom reports
  • Access and export a complete and reliable audit trail

The solution

FinScan helps healthcare providers, life and health insurance carriers, and pharmacies ensure that they comply with Medicare/Medicaid exclusion and AML screening regulations.

Compliance screening

Screen against OIG LEIE, SAM.gov EPLS, and state-level exclusion lists.

AML screening

Screen against sanctions and watch lists, PEP databases, and your own lists.

Data prep

Leverage our superior data quality engine to improve the patient experience.

Ultimate Beneficial Owner

Identify and screen Ultimate Beneficial Owners of entity customers.

Transaction Screening

Automatically detect and stop high-risk transactions in real time.

ID Validation

Detect fraudulent IDs and screen against any watch lists instantly.

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