One-time Exclusion Screening is a healthcare compliance batch exclusion screening service that compares your list of healthcare providers, employees, vendors, and contractors against the OIG LEIE, SAM, CMS, NPI, FDA, and State Medicaid exclusion lists, delivering a consolidated, comprehensive downloadable exclusion screening report—starting at just $25 for up to 100 providers screened.
There are over 320,000 exclusions reported in total by the OIG, SAM, and State Medicaid Agencies. Save yourself a lot of time and effort—Upload your provider list, and we will deliver you a complete, consolidated Exclusion Report in minutes!
Just $25 / 100 Providers
The $25 service fee covers a batch screening of up to 100 providers. Each additional group of 100 is charged an additional $25. A list containing 1–100 providers costs $25, 101–200 providers cost $50, 201–300 cost $75, and so on. No subscription or account is required for one-time screening.
✓ No Subscription required
✓ No User Account required
✓ Upload Provider List as Excel, CSV, or TXT file
✓ Pay only for providers uploaded in batches of 100
✓ Download Comprehensive Exclusions Screening Report
Why use One-time Exclusions Screening
One-time Exclusions Screening is useful for new provider onboarding, credentialing, vendor screening, or periodic compliance checks. It’s ideal for small organizations with a limited number of providers that want to verify exclusions and gather documented evidence themselves.
One-time Exclusions Screening is used for:
- New provider onboarding
- A compliance review
- An internal audit
- Credentialing
- Enrollment
- Vendor screening
- Contracting
- Periodic compliance checks
- A specific provider population
How One-time Exclusion Screening Works
One-time exclusion screening works by matching each provider from your uploaded list against federal and state exclusion databases. After you upload your file and pay, the system checks each record and prepares a downloadable Exclusion Screening Report for you to review.
Step 1: Upload your provider list
Upload an Excel, CSV, or text file containing the providers you want to screen. For the best match quality, include the provider’s NPI number when available, as it improves accuracy. Also, when available, provide the provider’s name, address, and license numbers.
In addition, we also search organization-authorized official names because exclusions are often reported for the authorized official rather than the organization name.
Step 2: Pay based on the number of providers
Your price is based on the number of providers screened at $25 per 100 providers uploaded. You will receive an email with a link to download the Exclusion Report, which opens the checkout page for payment.
Step 3: HealthProviders DB screens the list
In practice, the screening checks whether each provider is an exact match, a possible match that needs review, a reinstated record that has returned to active status, a deactivated NPI, an opted-out Medicare provider, or a clear match with no exclusion found.
What Databases Does Exclusion Screening Check?
| Database | What it identifies |
|---|---|
| OIG LEIE | Individuals and entities excluded from federal healthcare programs |
| SAM.gov | Federal exclusions and debarments |
| State Medicaid | State-specific Medicaid exclusions, terminations, and sanctions |
| CMS | Medicare opt-outs and revoked providers |
| FDA | FDA debarments and clinical investigator disqualifications |
| NPI | NPI deactivation status |
Step 4: Download and review your report
Your comprehensive Exclusions Report automatically downloads after payment and includes the provider’s full name, addresses, NPI number, license numbers, Medicare Opt-Out affidavit start and end dates, exclusion date, reason, reinstatement date, and primary-source links.
Exclusions have a status of Exact, Possible, Reinstated, Deactivated, Opted-out, or Clear, indicating whether the record is a confirmed match.
What do I do with the found exclusion matches?
The One-time Exclusions Screening Report makes verifying found exclusions much easier by including links to the exclusion’s primary source record on the reporting agency’s website, enabling quick verification and the collection of documented evidence. With the Exclusion Report and your documented evidence from the agency website for each exclusion found, you’re audit-ready!
What to do with exact matches
Exact and reinstated matches should be verified through the primary source on the reporting agency’s website, using the link provided in the Exclusion Report to gather documented evidence of your due diligence.
What to do with possible matches
A screening result should not be treated as a final determination solely from a name match. Possible matches should be reviewed against identifying information such as NPI, name, address, and license information and verified against the applicable primary-source government record. Organizations should then follow their compliance procedures and applicable requirements.
What to do with opt-out matches
Healthcare providers that have opted out of Medicare cannot receive Medicare reimbursements. Opted-out matches have start and end dates. You can use the primary source link to get the Medicare Opt-out affidavit.
What to do with deactivated NPI matches
Deactivated NPI matches mean the number is no longer valid. You can use the primary source link to get evidence from the NPI registry.
Watch How One-time Exclusion Screening Works
Watch this short demonstration to see how easy it is to submit a provider list and obtain your screening results.
An Exclusions Report You Can Actually Use
The Exclusions Report is designed to give you a consolidated view of your provider screening results, including the information needed to investigate and verify the exclusion matches.
The Exclusions Report includes:
- The provider’s full name and Addresses for identity and location matching.
- NPI Number and Deactivated Date for identity matching and active status checks.
- License Numbers, Active Status, and Expiration Date for license verification and current status review.
- Medicare Opt-Out Affidavit Start and End Dates for assessing Medicare participation status.
- Exclusion Date, Reason, Reinstatement Date, and Status of Exact, Possible, Reinstated, Deactivated, Opted-out, or Clear for identification and verification.
- Links to the exclusion primary source record on the reporting agency’s website for verification and collecting documented evidence.
Sample Exclusions Report
Do you need Continuous Exclusion Monitoring?
Continuous exclusion monitoring alerts you immediately to any new and updated exclusions for the providers you are monitoring against state and federal exclusion lists as the databases are updated on the reporting agency’s website.
Continuous Exclusion Monitoring Features include:
- Easily manage your list of all healthcare providers, employees, vendors, and contractors for continual exclusion monitoring.
- Automatic monthly updates imported from OIG, SAM, and State Medicaid Exclusion Lists and matched to your provider list.
- Automatic Exclusions Change Notifications.
- Comprehensive, always-current, and audit-ready Exclusions Report available for download anytime.
- Exclusions Dashboard with total Providers, Exclusions, Verifications, Reinstatements, Medicare Opt-out, and NPI deactivations.
- Built-in Exclusion Primary Source Verification Tools.
- Save Notes & Documented Evidence of Exclusion Screening.
Similar to One-time Exclusion Screening, exclusions found and matched to your providers require your verification and screening documented evidence to be compliant and audit-ready, and with a Continuous Exclusion Monitoring subscription, you can save notes and your documented screening evidence with the matched exclusion that is also included with the downloaded Exclusion Report for audit review.
Even small organizations can benefit from using the Continuous Exclusion Monitoring subscription.
One-time Screening vs Continuous Exclusion Monitoring
| One-Time Screening | Continuous Monitoring | |
|---|---|---|
| Best for | Small organizations and periodic checks | Ongoing compliance |
| Provider list | Upload when needed | Continuously maintained |
| OIG LEIE | ✓ | ✓ |
| SAM | ✓ | ✓ |
| State Medicaid | ✓ | ✓ |
| Automated monitoring | — | ✓ |
| Change notifications | — | ✓ |
| Save Audit documentation | — | ✓ |
| Price | From $25 | $89 Monthly subscription |
Frequently Asked Questions
What information do I need to screen a provider?
The NPI number is the preferred identifier when available. Provider name, address, and state license information can also help identify and verify potential matches.
What format should my provider list be?
Your provider list should be uploaded as an Excel, CSV, or text file. Include the provider’s NPI number, name, address, and any required license numbers.
What does the exclusion screening report contain?
The report includes provider identity information, NPI status, license information, Medicare opt-out status, exclusion status, exclusion dates, exclusion reasons, reinstatement information, and links to primary-source records for verification.
How quickly will I receive my report?
Your One-time Exclusion Screening starts immediately after payment is complete, and the report is automatically downloaded.
What happens with my uploaded provider list?
Your uploaded provider list is discarded immediately after processing and is not saved anywhere.
Does a screening result guarantee that a provider is eligible to participate in federal healthcare programs?
Screening results are provided as informational compliance-screening data. Organizations should independently verify potential matches and determine the appropriate action in accordance with applicable laws, regulations, contracts, and organizational policies.
What should I do if an excluded provider is found?
A screening result should not be treated as a final determination solely from a name match. Potential matches should be reviewed against identifying information such as NPI, name, address, and license information and verified against the applicable primary-source government record. Organizations should then follow their compliance procedures and applicable requirements.
Is exclusion screening a requirement?
Federal database checks under 42 CFR § 455.436 require all Medicare Advantage Plans, State Medicaid Programs, and Medicaid Managed Care Organizations to confirm providers’ exclusion status through routine checks.
Providers excluded by the Office of Inspector General (OIG), terminated by any State Medicaid Agency, or debarred from receiving federal contracts, grants, or financial assistance cannot participate in federally funded healthcare programs. This includes Medicare, Medicaid, TRICARE, and the Children’s Health Insurance Program (CHIP), federally funded healthcare programs. Additionally, the Centers for Medicare & Medicaid Services (CMS) has the authority to revoke billing privileges, prohibiting the provider from participating in Medicare.
How often should exclusion screening be done?
Federal guidance recommends checking the OIG LEIE and SAM at least monthly, and many states require or strongly recommend monthly checks.
The OIG recommends that healthcare organizations check their employees and contractors against the LEIE monthly in accordance with the Special Advisory Bulletin issued in May 2013.
Federal database checks section 42 CFR Part § 455.436(c)(2) says to check the LEIE and SAM no less frequently than monthly.
Who should be included in Exclusion Screening?
- Physicians
- Nurses
- Nurse practitioners
- Physician assistants
- Pharmacists
- Dentists
- Therapists
- Other healthcare professionals
- Administrative personnel
- Contractors
- Vendors
- Billing companies
- Medical equipment suppliers
- Transportation providers
- Other individuals/entities whose services may be reimbursed by federal healthcare programs
How much does One-time Exclusion Screening cost?
HealthProviders DB charges $25 for each batch of up to 100 providers. A list containing 1–100 providers costs $25, 101–200 providers cost $50, 201–300 cost $75, and so on. No subscription or account is required for one-time screening.
| Providers | Price |
|---|---|
| 1–100 | $25 |
| 101–200 | $50 |
| 201–300 | $75 |
| 301–400 | $100 |
| 401–500 | $125 |
| 501–1,000 | $250 |
HealthProviders DB provides data and screening services to assist organizations with exclusion screening and compliance processes. Screening results should be independently reviewed and verified, particularly when a potential match is identified. The service does not constitute legal, regulatory, or compliance advice and does not guarantee that an organization will satisfy its legal or regulatory obligations.