(413) 387-1040
139 B Damon Road, Suite 8, Northampton, MA 01060

Medicare Exclusion Testing

Medicare Exclusion Testing Software

Pioneer Training has developed a robust software solution that lets your company easily and efficiently compare lists of employees or contractors to federal and state Medicare/Medicaid exclusions lists.

This flexible, user-friendly software will help your organization to be in compliance with government watch/exclusion lists that are routinely updated with ineligible individuals or entities.

How the Software Works

The software is a locally-installed Access database. Since all of your data is stored and processed locally, it is not vulnerable to online security threats.

The base software loads your contacts, or your employee or vendor lists, and compares them to the following lists:

  • Office of Inspector General’s List of Excluded Individuals and Entities (OIG-LEIE).
  • Government Services Administration’s list of System for Award Management (GSA-SAM).
  • Massachusetts’ HHS List of Suspended or Excluded MassHealth Providers.

The software can be customized for other states.

The Matching Process

The software uses sophisticated pattern matching for names and addresses to flag exact matches to likely or possible matches based on a numeric ranking system.

Once the processing is complete, you review each name and mark it as a Match, Not a Match or Under Review. Once you flag a name, the software remembers it and doesn’t present it to you again. So, over time, you need to spend less time reviewing the full list.

Administering the Exclusion Testing

All activity is logged so you can easily review and report on your work.

If you need to “unexclude” a person, you can easily remove the matching flag.

The software also lets you import files in either Excel or CSV format.

Give us a call at (413) 387-1040, or submit the form on the right for more information!

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