Looking for a Verisys Alternative for OIG Exclusion Monitoring?

Fonteum vs Verisys

Federal exclusion data with field-level provenance

Ingest → provenance → deliver

Common questions

How does Fonteum monitor OIG LEIE exclusions?

Fonteum ingests the OIG HHS LEIE (List of Excluded Individuals and Entities) monthly CSV directly from oig.hhs.gov/exclusions/, on the same cadence the OIG publishes it. The current dataset contains 68,055+ excluded individuals and entities. Every record carries the federal source citation written into the provenance layer — oig.hhs.gov LEIE · download date · Fonteum methodology version — along with the exclusion type, the statutory authority for the exclusion (such as 42 U.S.C. § 1320a-7(a) mandatory exclusions), and the effective date. The aggregate surface is public at /sanctions and the underlying dataset is freely downloadable; custom compliance exports — for example, exclusions cross-referenced to a specific provider network or scoped by specialty — are available via the pilot tier from $2,500/mo. Because the ingest mirrors the OIG's own monthly schedule, the screening record stays aligned with the federal source health plans are required to check against.

Does Fonteum replace a credentialing workflow platform like Verisys?

No — and it is important to be precise about the boundary. Verisys and comparable platforms provide automated credentialing workflow management: task queues, re-credentialing schedules, CAQH integration, primary-source license checks, and continuous monitoring orchestration. Fonteum provides the underlying federal data layer those workflows depend on, with field-level provenance: OIG LEIE exclusion flags (68,055+ records, monthly refresh), CMS NPPES NPI and taxonomy (6.8M+ active providers), and CMS PECOS Medicare enrollment status — cross-referenced in one source-provenanced graph. Fonteum is the data tier, not the workflow tier. The right way to think about it: a credentialing team can drive its existing workflow platform with Fonteum's federally sourced, citable data via the FHIR R4 API, replacing or supplementing a vendor's proprietary exclusion list with the primary OIG file plus an auditable citation chain. Fonteum does not run the re-credentialing calendar; it makes the data feeding that calendar traceable to the federal record.

Can I download the OIG LEIE exclusion data directly from Fonteum?

Yes. The OIG LEIE dataset is available at /sanctions as a public research surface, and the underlying structured dataset is downloadable as CSV and JSON with no account required — the LEIE is a federal public work under 17 U.S.C. § 105, so Fonteum redistributes the provenance-tagged version openly. Every record traces to the OIG HHS LEIE file with the federal citation, the download date, and the methodology version. For production use cases that need more than the static file — bulk exports with custom cross-references such as NPI-matched exclusion flags scoped by specialty, geography, or an uploaded provider roster, or programmatic monthly delivery — the pilot tier provides scoped datasets and FHIR R4 API access from $2,500/mo. This open posture contrasts with per-seat or per-entity enterprise pricing, where the same federal exclusion list sits behind a five-figure annual contract.

Does Fonteum cross-reference OIG exclusions with NPI records?

Yes. Fonteum's source-provenance graph joins OIG LEIE exclusion records with CMS NPPES NPI data (6.8M+ active providers) and CMS PECOS Medicare enrollment status. The cross-reference is surfaced on provider profiles: an excluded provider shows the LEIE flag alongside their NPPES taxonomy, practice address, and PECOS enrollment indicator — each field carrying its own federal source citation and last-checked date. The join methodology, including how Fonteum handles name-and-identifier matching between the LEIE (which keys on individual and entity identifiers) and NPPES (which keys on NPI), is documented at /data-provenance, with match confidence preserved rather than collapsed. This matters because exclusion screening turns on correct identity resolution: a false match flags a clean provider, a missed match clears an excluded one. By keeping the provenance and match basis visible, Fonteum lets a compliance team see why a given NPI is or is not tied to an exclusion record, instead of trusting an opaque proprietary matcher.

Why does field-level provenance matter for exclusion screening audits?

CMS requires Medicare Advantage organizations and Medicaid managed-care plans to screen providers against the OIG LEIE monthly, and to be able to demonstrate that screening in an audit. The audit question is not merely 'did you check?' but 'against which version of the federal list, on what date, and can you show the record?' A platform that returns a proprietary clean/excluded verdict without surfacing the underlying OIG file, download date, and match basis leaves a gap in that audit trail. Fonteum closes it: every exclusion record carries the oig.hhs.gov LEIE citation, the monthly download date, the exclusion type and statutory authority, and the methodology version, all written to the provider_field_provenance layer. When an auditor asks for the basis of a screening decision, the answer is the federal record itself with its date stamp — not a vendor's derived list. That is the difference between defensible primary-source documentation and a black-box result.

Is Fonteum's data free, and what does the pilot tier add?

The /sanctions OIG LEIE surface and the underlying research dataset are free to access and cite, as are Fonteum's other federal datasets at /research — no account, no API key for the static files. This is possible because the source records are federal public works. The paid pilot tier ($2,500–$5,000/mo) is for teams that need production capabilities on top of the open data: custom export scoping (exclusions matched to your provider roster, or cross-referenced with NPPES taxonomy and PECOS enrollment), FHIR R4 US Core 6.1.0 API access with SMART Backend Services auth for system-to-system integration, HL7 bulk $export for large pulls, methodology-versioning commitments so your pipeline is pinned to a stable schema, and a 30-day no-penalty exit. The pricing model is deliberately inverted from the enterprise norm: the federal data is open, and you pay only for scoping, throughput, and integration support.

Explore the OIG exclusion data.

The /sanctions surface and OIG LEIE research dataset are free. For custom compliance exports, request access.

• /sanctions → OIG LEIE exclusion aggregate surface — 68,055+ excluded providers.
• /sources → OIG LEIE source family documentation — tier, refresh cadence, redistribution posture.
• /data-provenance → How OIG LEIE, NPPES, and PECOS cross-references are provenanced.
• /use-cases/payer-credentialing → Provider credentialing data for health plan compliance teams.