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8 Common Provider Credentialing Mistakes and How to Avoid Them

Verisys

3: Allowing a physician to treat patients before credentialing is completed Courts have held hospitals liable when a physician falsifies credentials, and the hospital fails to do its due diligence in verifying them. This creates the potential for adverse patient outcomes, leading to expensive malpractice lawsuits. Mistake No.

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Why Is Credentialing Management Software Important?

MedTrainer

Thoroughly reviewing and verifying credentials helps organizations identify any gaps or issues that may pose risks to patient safety, such as expired licenses or malpractice claims. Fines, medical malpractice claims, and patient harm are concerns if credentialing isn’t properly managed. Risk Mitigation.

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Eight Common Physician Credentialing Mistakes

Verisys

Credentialing lapses can expose a healthcare organization to malpractice suits and accreditation problems. This creates the potential for negative patient outcomes, which can lead to expensive malpractice lawsuits. Therefore, due diligence requires background checks to identify both current and historical adverse actions be performed.

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How To Avoid Negligent Credentialing in ASCs

MedTrainer

Negligent credentialing occurs when healthcare facilities grant privileges to medical professionals to practice within their facility without first conducting due diligence in assessing their qualifications, competence, and ethical standing. What Is Negligent Credentialing? Financial Consequences. Long-Term Consequences.

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What Is Provider Credentialing?

MedTrainer

It involves collecting and reviewing information such as education, training, licensure, certifications, work history, malpractice history, and references — all in pursuit of verifying that providers are who they say they are and qualified to deliver legitimate, safe, and ethical care. But how do you know which one to choose?

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What Is the Credentialing Process?

MedTrainer

Comprehensive background checks help rule out any criminal history, malpractice claims, disciplinary actions, or other records that might send up red flags. Network Analysis Performed To avoid duplicate profiles with payers, a credentialing service should conduct due diligence in running a network analysis. Background Checks.

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Representations and Warranties Insurance in Physician Practice Acquisitions

Hall Render

The scope of coverage aligns with the scope of the seller’s reps and warranties in the purchase agreement, subject to buyer’s diligence and certain common exclusions. Coverage is contingent upon the buyer completing sufficient due diligence to confirm that the seller can stand behind its reps and warranties.