Physician Credentialing Company

JULY 15, 2024

This involves checking education, training, licensure, and professional experience to ensure compliance with legal and professional standards. It not only supports compliance with regulations but also enhances the credibility of healthcare facilities. It also involves checking for any disciplinary actions or malpractice history.

Malpractice 52

Malpractice Compliance Licensing Medical Billing 52

MedTrainer

MARCH 30, 2024

Enrollment delays cost nearly a third of organizations polled in a 2023 MedTrainer survey money, and 26% believe credentialing delays increase compliance risks that can significantly drain coffers. Any delay in the provider enrollment process means less revenue for the organization – and the longer the holdup, the harder the hit.

Malpractice 98

Malpractice Licensing Medicaid Medicaid 98

Compliancy Group

OCTOBER 18, 2024

Some of the most common challenges in healthcare credentialing involve documentation and administrative shifts, compliance changes and differences based on site locations, and incomplete or inconsistent information. Aside from the monetary savings, using healthcare credentialing software simplifies and streamlines the entire process.

Compliance 52

Compliance Regulatory Compliance Malpractice Licensing 52

AIHC

AUGUST 30, 2023

What compliance issues need to be considered when drafting a marketing strategy? Let’s take a closer look at potential compliance risks. As with all marketing strategies, remember Compliance, Compliance, Compliance! So, what is telemarketing in healthcare ? Great idea, right? I can’t say it enough.

Compliance 52

Compliance Fraud Medicare Medicare 52

MedTrainer

JULY 22, 2024

As organizations strive to maintain the highest standards of care, adopting the best healthcare credentialing software is a strategic move that enhances operational efficiency and ensures compliance with industry regulations. See enrollment status, time since submittal, missing documents, and more in real time.

Licensing 52

Licensing Compliance Malpractice Hospitals 52

MedTrainer

MAY 30, 2024

Healthcare credentialers must collect an average of 30 documents per provider to initiate and complete the credentialing process – also known as primary source verification (PSV). They also conduct background checks, which require calling law enforcement and other regulatory agencies for criminal records and malpractice history.

Licensing 52

Licensing Malpractice Medicare Medicare 52

MedTrainer

JULY 10, 2023

That’s why medical credentialing is such a crucial part of compliance for healthcare organizations and the providers working within them. It’s an absolutely essential part of compliance management. There are numerous important objectives behind the process of medical credentialing — many of them rooted in compliance.

Malpractice 52

Malpractice Compliance Licensing Hospitals 52

Medisys Compliance

MARCH 21, 2023

By verifying a doctor’s credentials, insurance companies can mitigate the risk of malpractice claims and ensure patient safety. Compliance with regulatory standards: Credentialing is a necessary component of complying with state and federal regulatory requirements.

Doctors 52

Doctors Malpractice Licensing Medical Billing Outsourcing 52

MedTrainer

AUGUST 5, 2024

The extensive administrative workload required to gather, verify, and review all necessary documentation can strain staff and delay bringing new providers on board, directly impacting patient care and revenue. Provider Document Uploads: Providers can upload all documents, licenses, and more through a secure link.

Compliance 52

Compliance Licensing Medicaid Medicaid 52

MedTrainer

MARCH 12, 2024

Types of Reportable Healthcare Events Reportable events in healthcare describe a spectrum of occurrences that require formal notification and documentation. Legal Implications: The landscape of medical malpractice and legal liability is intrinsically linked to reporting. The post What Are Reportable Events in Healthcare?

Compliance 52

Compliance Malpractice Governance Public Health 52

Compliancy Group

MAY 9, 2024

More compliance officers are prioritizing a solution that helps reduce this type of strain: GRC automation. Centralizing your Governance, Risk, and Compliance (GRC) processes is a simple way to streamline your compliance efforts. This is why compliance officers are prioritizing GRC automation.

Compliance Officers 52

Compliance Officers Compliance Malpractice Governance 52

MedTrainer

APRIL 27, 2024

Known for requiring a high level of documentation, OSVs add additional pressure and unique protocols regarding HRSA credentialing. Not to mention, HRSA-funded organizations typically have a wide range of provider types, which means differing processes, requirements, and documentation.

Licensing 52

Licensing Compliance Malpractice Governance 52

MedTrainer

APRIL 18, 2024

With a whole new group of provider enrollments starting from scratch, credentialers will likely be juggling towers of documents and data for the foreseeable future. Credentialing Documentation: Behavioral health providers must gather and submit extensive documentation for the Medicare enrollment process.

Medicare 52

Medicare Medicare Licensing Compliance 52

Physician Credentialing Company

JULY 23, 2024

HIPAA Compliance Certification: A vendor may not be aware of the HIPAA rules and policies; thus, it is important to train vendors on the regulations and provide certificates. Background Checks: Any criminal record, dishonesty issues, and malpractice claims. All documents should also be legal and accurate.

Hospitals 52

Hospitals Compliance HIPAA Malpractice 52

MedTrainer

SEPTEMBER 5, 2024

Health organizations must complete National Practitioner Data Bank or NPDB credentialing to maintain compliance with federal regulations. Organizations must register for an account, submit the required documentation, and receive authorization before searching the National Practitioner Data Bank.

Malpractice 52

Malpractice Fraud Licensing Compliance 52

Compliancy Group

OCTOBER 17, 2023

With the healthcare industry constantly transforming and adapting, managing risks has become a critical aspect of ensuring patient safety, organizational resilience, and regulatory compliance. Rated #1 on G2 “Compliancy Group makes a highly complex process easy to understand.” Please Wait. Something is wrong with your submission.

Regulatory Compliance 52

Regulatory Compliance Compliance Malpractice Fraud 52

Healthcare IT Today

NOVEMBER 13, 2024

Some states may accept Medicare enrollment as proof of compliance, while others demand a completely separate credentialing process. For instance, Arizona demands a 10-year history of any sanctions on a provider’s license, while others ask about past malpractice suits.

Medicaid 66

Medicaid Medicaid Hospitals Malpractice 66

MedTrainer

JULY 10, 2023

That’s why medical credentialing is such a crucial part of compliance for healthcare organizations and the providers working within them. It’s an absolutely essential part of compliance management. There are numerous important objectives behind the process of medical credentialing — many of them rooted in compliance.

Malpractice 40

Malpractice Compliance Licensing Hospitals 40

Verisys

AUGUST 17, 2023

Compliance with regulatory standards Compliance with regulatory standards from CMS or other regulatory-setting bodies should be non-negotiable. Mitigating liability and legal risks Malpractice claims and legal disputes can financially and emotionally drain healthcare providers and organizations.

Malpractice 52

Malpractice Licensing Compliance Medicaid 52

Physician Credentialing Company

SEPTEMBER 19, 2024

Compliance And Liability Issues Seeing patients without payer credentialing being done leads is risky, and providers may face legal issues. If something goes wrong while providing medical services, providers do not have any legal protection and have to face malpractice claims.

Malpractice 52

Malpractice Medicare Medicare Medicaid 52

MedTrainer

JUNE 29, 2023

They play a vital role in ensuring regulatory compliance, patient safety, and general risk mitigation. That said, organizations that are large enough to appoint a full-time CRO commonly have the same level of demand for risk management and compliance. Compliance and regulatory oversight. Insurance and claims management.

Regulatory Compliance 52

Regulatory Compliance Compliance Malpractice 52

MedTrainer

JULY 28, 2023

That mean, maintaining compliance standards, efficient reporting, and conducting thorough internal audits are vital. Download “Compliance Reports You Can’t Live Without” for OIG reporting templates and tips. This is done to ensure compliance with regulations, identify areas for improvement, and assess program effectiveness.

Fraud 98

Fraud Compliance Medicaid Medicaid 98

MedTrainer

APRIL 11, 2024

Incident reporting is essential to maintain a healthcare organization’s compliance with state and federal regulations and reveal what are the main types of healthcare incidents. An incident report is thorough documentation of the incident , including all relevant details that caused it and any outcomes that stemmed from it.

Compliance 52

Compliance Informed Consent Malpractice Hospitals 52

MedTrainer

AUGUST 2, 2023

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. Why Is Provider Credentialing Important?

Malpractice 52

Malpractice Due Diligence Compliance Licensing 52

MedTrainer

AUGUST 9, 2023

The exact timeline depends heavily on the complexity of the provider’s background, the efficiency of the organization’s credentialing process, and the completeness of the provider’s documentation. What Documents and Information Are Required? Malpractice Insurance. Licenses and Certifications. Work History.

Malpractice 52

Malpractice Licensing Compliance 52

Physician Credentialing Company

JULY 2, 2024

Credentialing is vital for maintaining patient safety, upholding regulatory compliance, and enabling providers to participate in insurance networks. Licensure Documentation of completed residency and fellowship training programs is required. Lack of Documentation Missing or outdated documentation can cause complications.

Licensing 52

Licensing Compliance Nurses Malpractice 52

Verisys

AUGUST 31, 2023

Here are seven red flags to look out for and the reasons why: Incomplete or inconsistent application: Missing or conflicting data regarding education, training, work history, licensure, or malpractice history might indicate false information or attempts to conceal relevant details.

Malpractice 52

Malpractice Fraud Medicaid Medicaid 52

MedTrainer

JULY 10, 2023

The process involves collecting and verifying relevant documents, conducting background checks, contacting references, and assessing the information gathered. Malpractice history. Investigation of any malpractice claims or disciplinary actions filed against the physician, including settlements or judgments. Work history.

Malpractice 40

Malpractice Licensing Compliance Regulatory Compliance 40

MedTrainer

MARCH 14, 2024

Additionally, the credentialing specialist may request a record of any pending and past medical malpractice cases and disciplinary actions from the appropriate authority. Meets compliance standards: Both processes verify a provider has met compliance standards. Look for these 10 attributes in a credentialing specialist.

Malpractice 52

Malpractice Licensing Hospitals Compliance 52

Medisys Compliance

OCTOBER 30, 2023

Compliance: Proper credentialing and billing are essential for remaining compliant with state and federal regulations , avoiding legal issues, and protecting the practitioner’s reputation. Submit Applications: Send the completed applications along with the required documents to the insurance companies.

Medical Billing Outsourcing 59

Medical Billing Outsourcing Medical Billing Malpractice Licensing 59

MedTrainer

SEPTEMBER 20, 2023

Legal costs, settlements, and increased malpractice insurance premiums can put financial burdens on ASCs found guilty of negligent credentialing. Document a Standard Process Establish a standardized credentialing process that outlines the specific criteria and requirements for granting privileges to providers at a given facility.

Malpractice 52

Malpractice Licensing Due Diligence Compliance 52

MedTrainer

JUNE 29, 2023

Healthcare credentialing involves verifying various aspects of a healthcare professional’s background, including their education, training, certifications, licenses, work history, malpractice history, and any other relevant credentials. With everything in a centralized repository, compliance also becomes easier.

Licensing 52

Licensing Compliance Malpractice Hospitals 52

Physician Credentialing Company

OCTOBER 25, 2024

These codes are crucial in ensuring that medical services are accompanied by the right documentation and billing practices making the healthcare system effective. Differences between 90834 and similar codes, documentation requirements, and CPT code 90834 reimbursement tips will also be discussed.

Licensing 52

Licensing Medical Billing Telemedicine Medicare 52

AIHC

SEPTEMBER 5, 2023

Compliance Considerations for Best Outcomes Written in collaboration with the AIHC Volunteer Education Committee Delivering mental health services via telehealth has increased since the COVID-19 pandemic. Telemedicine is considered to be under the umbrella of telehealth and refers specifically to clinical services.

COVID-19 59

COVID-19 Telemedicine Informed Consent Compliance 59

MedTrainer

APRIL 18, 2024

Credentialing Delays: The credentialing process can be lengthy, often involving gathering and verifying extensive documentation, including education, training, licensure, certifications, malpractice history, and references. Surveyors will often ask for a specific document or date, so the credentialer has to be ready!

Licensing 52

Licensing Malpractice Compliance 52

Physician Credentialing Company

SEPTEMBER 10, 2024

Gather Required Credentials Before starting the process, it is necessary to know the companies’ credentialing requirements and gather all necessary documents to make the process smooth and efficient. You need to submit the application to the insurance companies along with all necessary documents. It is not true for all companies.

Licensing 52

Licensing Malpractice Medical Billing Doctors 52

Medisys Compliance

MARCH 27, 2023

Insurance verification: The insurance company verifies that the provider has adequate malpractice insurance coverage. Reduces liability: By verifying a healthcare provider’s credentials, healthcare organizations can reduce their liability in the event of malpractice or other issues.

Malpractice 52

Malpractice Medical Billing Outsourcing Governance Patient Satisfaction 52