Compliance monitoring
Exclusion and expirable monitoring that never sleeps.
OIG and SAM exclusion screening, license and DEA expiry tracking, and board action monitoring across the roster, because finding it first is the whole game.
Sample file, shown for illustration.
Compliance Monitoring: the numbers that run it
the OIG updates its exclusion list, which is why monthly screening is the standard
of the workforce needs screening, not just clinicians
every claim tied to an excluded person is an overpayment plus penalties
grace period when a payer finds it before you do
Exclusion liability is strict. Bill a federal program for work an excluded person touched, and the claims are overpayments with penalties attached, whether or not anyone knew. The list changes monthly, people's status changes mid-employment, and screening once at hire proves only that someone was clean on one particular day. That is why the operating standard is the roster, the whole workforce, against the OIG and SAM lists, every month, with a record kept of every check.
Expirables are the quieter half of the same problem. Licenses, DEA registrations, certifications, and malpractice cover each expire on their own schedule, and the default tracking instrument, a spreadsheet somebody owns until they leave, fails exactly when it matters. A lapsed license does not stop the schedule; it just converts every visit after the lapse into a claim problem and a payer-notification obligation nobody wants to write.
Monitoring is the cheapest insurance in the credentialing stack: a standing monthly cycle, an expirables calendar with escalating lead times and named owners, board actions watched so bad news arrives from us rather than from a payer termination letter, and evidence generated as a by-product so an auditor's request is an export, not a scramble.
Where it goes wrong
The three failure modes we see weekly
Exclusions are strict liability
Knowledge is not the test; billing is. One excluded employee in the revenue path makes every associated claim an overpayment, discovered at repayment time.
Expirables live in spreadsheets
The license tracker is only as alive as the person who owns it. Staff turnover kills it silently, and lapses surface as denial batches months later.
Board actions surface late
An action in one state ripples into payer terminations everywhere, and payers often know before the employer does.
How this one is different
Three claims you can check
Exclusion screening monthly, across the whole roster
OIG's list plus the state lists
Federal rules expect monthly screening, and the OIG's exclusion list held more than 83,000 entries as of August 2026, alongside dozens of state lists that never fully sync with it. Every provider and the organization itself gets screened every month, matches get reviewed by a person rather than auto-cleared, and the sweep result is on record where an auditor can see it.
Every expirable on one calendar with a named owner
CAQH, licenses, DEA, COIs, board certs
The clocks that stop claims all tick at different speeds: CAQH dies every 120 days, licenses and DEA run multi-year cycles, malpractice certificates renew annually, recredentialing comes around on cycles like Humana's 36 months. Each date carries a named owner and gets worked ahead of the deadline, because a calendar nobody owns is how lapses happen.
Revalidations watched on the public lists
The mailbox is the backup, never the system
Medicare posts revalidation due dates about seven months ahead on a public list, and missing one deactivates billing with a gap that can never be recovered. We monitor the published list for every enrolled provider and the organization, so the deadline is on our calendar two quarters before any letter reaches any mailbox.
The scope
Everything this covers
Exclusion screening
Monthly OIG and state list sweeps across every provider and the organization, with human review on every match.
CAQH attestations
The 120 day cycle scheduled and owned, so no payer ever reads a lapsed profile mid-review.
License and DEA renewals
Every board and registration cycle tracked, renewed ahead of deadline instead of after the lapse.
Medicare and Medicaid revalidations
Due dates monitored from the public lists, filings prepared while the window is months wide.
Malpractice and COIs
Coverage renewals tracked so a certificate never expires inside a payer's review window.
Recredentialing cycles
Commercial payers recredential on their own multi-year clocks. Each one sits on the same calendar as everything else.
What you get
What we do about it
Monthly exclusion screening
Full roster, clinicians and staff, against OIG LEIE and SAM on a monthly cycle matched to the list updates, with the per-check audit trail kept automatically.
Expirables calendar
Every license, DEA, certification, and policy tracked with escalating lead-time alerts and named owners, so nothing depends on the spreadsheet surviving its author.
Board action monitoring
State board activity watched across the roster so a problem reaches you as an early briefing, not as a termination letter.
Evidence on demand
When a payer, delegate audit, or regulator asks for proof of screening, the record already exists in exportable form.
In your client portal
The watched calendar, in the open
Compliance monitoring earns its keep on the days nothing happens, which is exactly why it needs to be visible. Your portal shows the roster's compliance state at a glance: the last exclusion sweep and its result, what expires next and who owns it, which attestations come due this month, and any revalidation on the horizon.
The full process, step by stepSample data, for illustration.
The operating rhythm
How it runs
- 1
Baseline.
Full roster screened, current findings investigated and resolved. - 2
Monitor.
Monthly screening cycle plus the standing expirables calendar. - 3
Alert.
Findings escalated same day, with what it means and what to do attached.
The research this service runs on
Medicare revalidation deadlines
The five year clock with no grace period, and how to find your dates today.
Read itThe CAQH guide
The 120 day attestation cycle this service keeps from ever lapsing.
Read itWhy applications get rejected
Expired documents and stale attestations are preventable with exactly this calendar.
Read itAsked constantly
Straight answers
We screen new hires. Why is that not enough?
Because exclusion status changes after hiring. A clean hire can be excluded two years in, and every claim from that day forward carries the liability. The OIG refreshes its list monthly, which is exactly why monthly rescreening of the whole roster is the standard that survives an auditor's questions, and annual-only screening does not.
Who counts as needing screening?
Everyone the money touches: clinicians, billing staff, front desk, management, contractors, and vendors in the claims path. Exclusion violations regularly involve non-clinical staff, because the rule follows the federal dollars, not the clinical license.
What happens when a screen finds a match?
First, verification, because name matches are often not your person, and the record has to show the resolution either way. If it is your person, the response is immediate: remove them from federal-program work, quantify the exposure window, and take advice on repayment obligations. What turns a bad day into a catastrophe is the finding sitting unread; same-day escalation exists to prevent exactly that.
Can this cover contractors and vendors too?
Yes, and it should. The obligation extends to anyone furnishing items or services in the federal claims path, which includes staffing agencies, billing vendors, and management companies. We screen the entities and, where appropriate, their rostered people.
When was the last full-roster exclusion check? If you have to guess, it is due.
Tell us your roster and where things stand today. You get a realistic timeline and a written price the same business day.