Exclusion screening options for small healthcare employers: manual search vs ExclusionWatch vs enterprise vendors

If you employ people in a healthcare setting that bills Medicare or Medicaid, you need to screen your roster against the OIG's List of Excluded Individuals and Entities (LEIE) — ideally every month. You have three realistic ways to do it: run the searches yourself using OIG's free online tool, use a low-cost automated service like ExclusionWatch, or sign with an enterprise compliance vendor such as ProviderTrust, Verisys, or Streamline Verify. The short answer: manual works if your roster is tiny and you are disciplined about documentation; ExclusionWatch fits small employers who need automated LEIE screening with an audit trail at a predictable price; enterprise vendors are the right call for larger, multi-state organizations that need coverage beyond the federal list. This page walks through the honest trade-offs of each.

The three realistic options

Every exclusion screening approach is doing the same fundamental job: comparing the people who work for you against government exclusion databases, month after month, and producing evidence that you did it. The options differ in how much of that job is automated, how many databases get checked, and what it costs.

• Manual search — using OIG's free online LEIE search tool yourself, name by name, and keeping your own records.
• ExclusionWatch — an automated monthly LEIE screening service built specifically for small rosters, from $49/month.
• Enterprise vendors — ProviderTrust, Verisys, Streamline Verify, and similar platforms offering multi-list monitoring, license verification, and compliance program tooling for larger organizations.

Option 1: Manual screening with OIG's free tool

OIG maintains a free online searchable database where anyone can look up an individual or entity, and it publishes a downloadable version of the LEIE that is refreshed by the 10th of each month. If a name matches, you can verify the hit against an SSN or EIN. For a genuinely tiny roster — an owner and a handful of staff — this is a legitimate approach, and it costs nothing. You can try the same kind of lookup with our free single-name LEIE check.

The problems show up at roster scale and over time. Searching 30 or 60 names by hand every month is tedious enough that it tends to slip — and a skipped month is exactly the gap an auditor will ask about. Common names generate the same false positives every single month, and you re-investigate them every single month. Most importantly, the tool produces no record that you ran the check: unless you build your own system of screenshots, dated spreadsheets, and verification notes, you have screening without evidence of screening. In an audit, the evidence is most of the point. Our step-by-step manual screening guide covers how to do this properly if you go this route.

Option 2: ExclusionWatch

ExclusionWatch automates exactly one job: screening a small roster against the federal OIG LEIE every month and documenting it. You upload or type in your roster, and every month each entry is screened against the current LEIE, potential matches are flagged for review, and an audit-ready report is generated and archived. When you investigate a flagged match and clear it as a false positive, that decision is remembered — the same common-name hit does not come back next month as a new alarm. You can see what the output looks like in a sample report.

Pricing runs $49–149/month depending on roster size, month-to-month with no annual contract, no per-seat fees, and no implementation fees. There is a 14-day free trial that does not require a card, and setup is self-serve in about 10 minutes — there is no sales call because there is nothing to scope.

The honest limitation: ExclusionWatch covers the federal OIG LEIE only. It does not screen SAM.gov, state Medicaid exclusion lists, or licensing boards, and it does not verify licenses or integrate with HR systems. Several states require screening their own Medicaid exclusion list in addition to the LEIE — see our state Medicaid exclusion list guide to check your state's requirements. If your obligations extend well beyond the LEIE, an enterprise vendor is the better fit, and we would rather tell you that here than have you find out later.

Option 3: Enterprise vendors (ProviderTrust, Verisys, Streamline Verify)

If you are searching for a "ProviderTrust alternative" or "Verisys alternative," it is worth being clear about what these platforms actually do, because they do a great deal more than monthly LEIE checks — and for the organizations they serve, they are good products.

• ProviderTrust offers automated exclusion monitoring across the OIG LEIE, SAM.gov, and state Medicaid exclusion lists, plus license and credential verification, and serves hospitals, health systems, provider groups, and post-acute organizations.
• Verisys maintains FACIS, a proprietary database it describes as drawing on more than 3,000 primary sources and over 10 million records, spanning federal and state sanctions, licensing board actions, and more, alongside license verification and credentialing services.
• Streamline Verify automates monthly monitoring against the LEIE, SAM.gov, and state exclusion databases, and offers a full-service enterprise tier that takes screening off your team's plate entirely.

These vendors win decisively on breadth: multi-list coverage, primary-source license verification, integrations with HR and applicant tracking systems, dedicated support, and tooling for running a formal compliance program across facilities and states. None of the three publishes standard pricing; enterprise exclusion-monitoring contracts are typically quoted through a sales process and generally land in the thousands of dollars per year, usually on annual agreements. For a 200-bed hospital or a multi-state staffing agency, that is money well spent. For a 12-person home care agency that needs monthly LEIE screening with documentation, it is more product — and more procurement — than the problem requires.

Which should you choose?

Choose manual screening if your roster is one to five people, you will genuinely run the check every month without fail, and you will keep dated records of every search and every match investigation. The tool is free and official; the discipline is the hard part.

Choose ExclusionWatch if you are a small healthcare employer — a home care or hospice agency, dental or therapy practice, small clinic, or group home operator — with up to roughly 500 roster entries, your core obligation is monthly LEIE screening, and you want it to happen automatically with an audit trail. If your state also requires screening its Medicaid exclusion list, you can pair ExclusionWatch with a short manual state-list check, or step up to an enterprise vendor.

Choose an enterprise vendor if you operate across multiple states, need SAM.gov and state Medicaid list coverage handled for you, verify and monitor professional licenses at scale, or need integrations with your HR stack and a vendor relationship with dedicated support. At that complexity, the enterprise price buys real value.

Frequently asked questions

Is screening only the OIG LEIE enough to be compliant?

It depends on your state and payer requirements. The LEIE is the core federal list, and monthly LEIE screening is the baseline OIG guidance points to. But a number of states require Medicaid providers to also screen the state's own exclusion list, and some organizations have contractual obligations to check SAM.gov. Check our state-by-state guide, and when in doubt, ask your compliance counsel.

Why do enterprise vendors cost so much more?

Because they do much more: aggregating dozens of federal and state sources, verifying licenses against primary sources, maintaining integrations, and staffing support and implementation teams. That cost structure makes sense for large organizations. The gap in the market is that small employers were being asked to buy all of it to get the one piece they need — which is the gap ExclusionWatch exists to fill.

How often does the LEIE change?

OIG updates the LEIE monthly, with exclusion and reinstatement data posted by around the 10th of each month. That monthly cadence is why a one-time hire-date check is not enough: someone clean at hiring can be excluded later, and monthly screening is how you catch it.

Can I switch approaches later?

Yes, and you should expect to. Plenty of organizations start with manual checks, move to ExclusionWatch as the roster grows, and eventually graduate to an enterprise platform if they expand into multiple states or add license monitoring needs. Since ExclusionWatch is month-to-month, there is no contract penalty for outgrowing it.