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

MedTrainer

NOVEMBER 27, 2023

Managing healthcare compliance in Ohio presents a unique set of challenges for compliance officers, healthcare professionals, and administrators. Organizations need to successfully navigate the regulatory landscape in order to provide efficient and ethical healthcare services, and to avoid consequences for non-compliance.

Compliance 52

Compliance Licensing Medicaid Medicaid 52

Physician Credentialing Company

DECEMBER 20, 2024

It acts as a shield against malpractice claims under the False Claim Act. The following are some risks involved: Compliance risks Compliance with policies and regulations is considered a cornerstone in medical billing. Medicare and Medicaid allow non-credentialed providers to get reimbursement but under strict rules.

Medical Billing 52

Medical Billing Compliance Malpractice Regulatory Compliance 52

HIT Consultant

FEBRUARY 5, 2024

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. Thorough and ongoing physician screening is critical to avoid costly negligent credentialing and malpractice claims.

Malpractice 96

Malpractice Licensing Due Diligence Hospitals 96

Verisys

FEBRUARY 3, 2025

Ensuring compliance with healthcare regulatory compliance standards is essential to maintaining operational efficiency and delivering quality care. This includes verifying qualifications, submitting proof of malpractice insurance , and ensuring compliance with all healthcare regulatory compliance standards.

Malpractice 52

Malpractice Regulatory Compliance Licensing Compliance 52

Provider Trust

JULY 8, 2022

Department of Health and Human Services (HHS) and contains medical malpractice payments and adverse action reports on healthcare professionals. The best practice for finding exclusions and sanctions in addition to referencing the NDPB is to search the OIG LEIE and SAM.gov websites and all available state Medicaid exclusion lists.

Licensing 52

Licensing Malpractice Fraud Medicaid 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

Total Medical ComplianceHIPAA

JANUARY 11, 2024

In the intricate landscape of healthcare, compliance with regulations isn’t just a choice but a necessity. Regulatory Compliance: HIPAA mandates the protection of patient information and the prevention of fraudulent practices. HIPAA stands as a beacon of privacy and security standards within the industry.

HIPAA 52

HIPAA Malpractice Regulatory Compliance Compliance 52

Verisys

JANUARY 19, 2022

According to recent surveys of major metropolitan hospitals , departments that typically share the responsibility for credentialing include: The Compliance Office. Checks credentialing for Health Insurance Portability and Accountability Act (HIPAA) compliance. Human Resources. Medical Staffing Services.

US Department of Health and Human Services 52

US Department of Health and Human Services Hospitals Malpractice Compliance Officers 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. Store-and-forward is less commonly reimbursed by Medicare and Medicaid programs.

COVID-19 59

COVID-19 Telemedicine Informed Consent Compliance 59

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

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

Verisys

JULY 20, 2023

This creates the potential for adverse patient outcomes, leading to expensive malpractice lawsuits. Final thoughts Although provider credentialing may be tedious, the process safeguards healthcare facilities against risk and non-compliance. Mistake No. Mistake No. Contact us to learn more.

Due Diligence 52

Due Diligence Malpractice Licensing Hospitals 52

Verisys

FEBRUARY 2, 2025

They then verify that the documentation is accurate, genuine, current, and in good standing, ensuring compliance with all credentialing requirements. The Centers for Medicare and Medicaid Services (CMS) established credentialing by proxy as a way for telehealth practitioners to save time and money during the credentialing process.

Hospitals 52

Hospitals COVID-19 Licensing Medicare 52

Verisys

FEBRUARY 4, 2022

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. The NPDB requires reporting of the following actions: Medical malpractice payments. Mistake No. Mistake No.

Malpractice 52

Malpractice Licensing Due Diligence Hospitals 52

MedTrainer

SEPTEMBER 5, 2024

Health organizations must complete National Practitioner Data Bank or NPDB credentialing to maintain compliance with federal regulations. Explore more of MedTrainer’s products and the many benefits of using an all-in-one compliance platform today. The post Crucial Need for NPDB Credentialing appeared first on MedTrainer.

Malpractice 52

Malpractice Fraud Licensing Compliance 52

MedTrainer

AUGUST 5, 2024

Additionally, navigating the complex and frequently changing regulations and standards increases the risk of non-compliance, potentially leading to legal and liability issues. Compliance with Regulatory Requirements Healthcare organizations are legally responsible for verifying that all providers are properly credentialed and privileged.

Compliance 52

Compliance Licensing Medicaid Medicaid 52

Verisys

NOVEMBER 30, 2023

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. Thorough and ongoing physician screening is critical to avoid costly negligent credentialing and malpractice claims.

Malpractice 52

Malpractice Licensing Due Diligence Hospitals 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

FEBRUARY 5, 2024

Provider enrollment is when a healthcare provider is registered with insurance networks or government payers , like Medicaid or Medicare. Provider enrollment confirms the healthcare provider meets and maintains certain compliance standards for the insurance or payer network. What is Provider Enrollment? What is Provider Credentialing?

Licensing 52

Licensing Governance Compliance Fraud 52

Medisys Compliance

MARCH 27, 2023

These terminologies are briefly discussed below for better understanding: Provider enrollment: This refers to the process of enrolling a healthcare provider with an insurance plan or government program, such as Medicare or Medicaid. By meeting these requirements, providers can expand their patient base and increase revenue.

Medical Billing Outsourcing 52

Medical Billing Outsourcing Malpractice Governance Patient Satisfaction 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.

Malpractice 52

Malpractice Due Diligence Compliance Licensing 52

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

Verisys

DECEMBER 1, 2023

It allows organizations to stay compliant with state and federal requirements and maintains their accreditation with Medicare, Medicaid, TRICARE, and other programs. As a CVO that has achieved this certification, Verisys can give partner organizations peace of mind that it is meeting the rigorous compliance standards set forth by NCQA.

Medicaid 52

Medicaid Medicaid Medicare Medicare 52

Provider Trust

APRIL 14, 2023

After all, having the necessary credentials and licenses ensures provider network integrity and compliance, all while helping members receive safe, equitable, high-quality care. In addition, organizations should monitor reports about medical incidents, disciplinary action, and malpractice claims involving their providers.

Licensing 52

Licensing Compliance Malpractice Medicaid 52

AIHC

APRIL 25, 2022

Written by: Joanne Byron , BS, LPN, CCA, CHA, CHCO, CHBS, CHCM, CIFHA, CMDP, COCAS, CORCM, OHCC, ICDCT-CM/PCS This article addresses how to track telehealth policies while addressing HIPAA compliance and mobile device management as the United States enters into a post-pandemic era. What Additional Information Should I Know for Compliance?

HIPAA 52

HIPAA COVID-19 Compliance Compliance Officers 52

MedTrainer

DECEMBER 2, 2024

Diversification of Payer Sources FQHCs are not limited to government funding through Medicaid and Medicare. Familiarize yourself with any payer-specific requirements such as proof of malpractice insurance, state-approved alternatives, and specific forms like the special needs survey or disclosure of ownership statement.

Licensing 52

Licensing Malpractice Compliance Medicaid 52

Verisys

APRIL 27, 2023

Our solutions are fully accredited by NCQA and URAC, allowing us to maintain the industry’s highest data and compliance standards. As a credentialing verification organization , Verisys has a variety of solutions that can meet your organization’s credentialing needs.

Malpractice 52

Malpractice Licensing Fraud Medicaid 52

MedTrainer

APRIL 18, 2024

Here are some of the most common challenges for behavioral health credentialing and Medicare enrollment: Understanding Medicare Requirements: The Center for Medicare and Medicaid (CMS) divides counselors into two main categories: marriage and family therapist (MFT) and mental health counselor (MHC).

Medicare 52

Medicare Medicare Licensing Compliance 52

Verisys

MARCH 1, 2022

The Centers for Medicare & Medicaid Services (CMS) Medicare and state Medicaid lists show practitioners who have opted out of those programs. The policy issuer for malpractice insurance verifies insurance coverage. Credentials Verification Organizations to the Rescue?

Governance 52

Governance Licensing Malpractice Medicaid 52

MedTrainer

MARCH 5, 2025

While many healthcare organizations still rely on manual or decentralized credentialing processes, the potential for verification errors could compromise patient safety and organizational compliance. Automated alerts can help identify and address compliance gaps before they become critical issues. With 75.7%

Licensing 52

Licensing Compliance Malpractice Medicare 52

Verisys

DECEMBER 23, 2021

Medicare, Medicaid, and TRICARE: How Enrollment Standards Differ. Provider enrollment in Medicare, Medicaid, TRICARE, and other government health programs all involve a lengthy process, with some variation. High number of malpractice cases. Software options to ensure provider data integrity and optimized enrollment management.

Medicare 52

Medicare Medicare Medicaid Medicaid 52

Medisys Compliance

MARCH 23, 2023

In our credentialing services we assist you in entire credentialing process for all insurance companies including Medicare and Medicaid. Review of work history: This includes reviewing the provider’s employment history, clinical experience, and any references or recommendations.

Medical Billing Outsourcing 52

Medical Billing Outsourcing Medical Billing Malpractice Health Insurance 52

Verisys

DECEMBER 5, 2023

The Centers for Medicare & Medicaid Services (CMS) Medicare and state Medicaid lists show practitioners who have opted out of those programs. The policy issuer for malpractice insurance verifies insurance coverage. Credentials Verification Organizations to the Rescue?

Governance 52

Governance Licensing Malpractice Medicaid 52

Hall Render

DECEMBER 12, 2023

On November 16, 2023, the Centers for Medicare & Medicaid Services (“CMS”) published proposed changes to the Medicare provider enrollment requirements in the Calendar Year 2024 Physician Fee Schedule final rule (“Final Rule”).

Medicare 40

Medicare Medicare Licensing Malpractice 40

Florida Health Care Law Firm

APRIL 20, 2022

Department of Health and Human Services, Statewide Medicaid Managed Care, Florida Department of Agriculture and Consumer Services, or another agency to continue to process your complaint. If you wish to file a complaint of malpractice with the Florida Medical Board, the process is especially tricky. Florida Medical Board Complaints.

Doctors 40

Doctors Malpractice Licensing Medicaid 40

Physician Credentialing Company

OCTOBER 25, 2024

Medicare and Medicaid may have different payment systems from those of the private health insurance plans. Documentation And Compliance Documentation is properly important during billing for 90834. They should also be informed when they are close to the set limit.

Licensing 52

Licensing Medical Billing Telemedicine Medicare 52