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. Who can Bill CPT Code 90834?

Licensing 52

Licensing Medical Billing Telemedicine Medicare 52

MedTrainer

JULY 22, 2024

It provides a centralized system for collecting, storing, and managing all the essential data and documentation related to a healthcare professional’s background, including education, training, certifications, licenses, work history, and malpractice history. Download the guide to Essential Credentialing Data.

Licensing 52

Licensing Compliance Malpractice Hospitals 52

Physician Credentialing Company

JULY 15, 2024

By validating staff competence, it reduces the likelihood of malpractice claims and legal issues. It also involves checking for any disciplinary actions or malpractice history. This includes verifying licenses, liability insurance, and education history. Healthcare facilities benefit financially from credentialing as well.

Malpractice 52

Malpractice Compliance Licensing Medical Billing 52

MedTrainer

MARCH 22, 2024

We’ll walk you through the steps in enrolling with Cigna, the information and documents you’ll need, common challenges you may encounter, and best practices to follow. The challenge is meeting each payer’s unique provider credentialing and enrollment process. In this blog, we’ll highlight how to navigate Cigna provider enrollment.

Malpractice 52

Malpractice Licensing Hospitals 52

Medisys Compliance

MARCH 21, 2023

By credentialing doctors, insurance companies can ensure that their customers receive high-quality care and that the doctors they work with are qualified and licensed to provide the care they need. By verifying a doctor’s credentials, insurance companies can mitigate the risk of malpractice claims and ensure patient safety.

Doctors 52

Doctors Malpractice Licensing Medical Billing Outsourcing 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. Government-issued picture identification.

Licensing 52

Licensing Compliance Malpractice Governance 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? Licenses and Certifications. Malpractice Insurance. Work History.

Malpractice 52

Malpractice Licensing Compliance 52

MedTrainer

MAY 15, 2024

Since surveyors are likely to perform an unannounced audit to review the provider credentialing files for a random provider document or recredentialing date, having everything stored in MedTrainer’s credentialing platform is really helpful. Make it easy for providers to submit documents. Primary Source Verification. Background Checks.

Malpractice 52

Malpractice Medicaid Medicaid Licensing 52

Physician Credentialing Company

SEPTEMBER 19, 2024

If something goes wrong while providing medical services, providers do not have any legal protection and have to face malpractice claims. Liability issues can even result in the termination of their license. These credentials are verified by the credentialing committee and they give a final report about the legitimacy of documents.

Malpractice 52

Malpractice Medicare Medicare Medicaid 52

MedTrainer

DECEMBER 20, 2023

Both licensing and credentialing processes are pivotal in upholding the integrity and safety of healthcare delivery in the state of New Jersey. The New Jersey State Board of Medical Examiners oversees medical credentialing and licensing within the state. Primary Source Verification. Payers in New Jersey have specific requirements.

Licensing 52

Licensing Medicaid Medicaid Malpractice 52

MedTrainer

MARCH 23, 2024

Many other licensed healthcare providers must be credentialed: nurses, physical therapists, speech pathologists, and behavioral health therapists. For example, a healthcare organization verifies a provider’s state license by calling or searching the state license registration board. BLS/ACLS certifications status.

Licensing 52

Licensing Malpractice Governance Nurses 52

Physician Credentialing Company

JULY 2, 2024

Educational Qualifications Providers must hold a valid license to practice in the state where they intend to work. This involves providing a copy of the license and verification from the licensing board. Licensure Documentation of completed residency and fellowship training programs is required.

Licensing 52

Licensing Compliance Nurses Malpractice 52

MedTrainer

SEPTEMBER 5, 2024

Typical organizations that may query the NPDB are: Hospitals Professional healthcare organizations or societies Boards of medical examiners State board of licensing Attorneys Drug Enforcement Agency Medical malpractice payers Most of these organizations must also report any adverse actions to the NPDB.

Malpractice 52

Malpractice Fraud Licensing Compliance 52

MedTrainer

MAY 29, 2024

Controlled Dangerous Substance (CDS) Required The Oklahoma State Bureau of Narcotics and Dangerous Drugs Control requires registration as well as a controlled dangerous substance (CDS) license. This is in lieu of a DEA license. Make it easy for providers to submit documents. Payers in Oklahoma have specific requirements.

Licensing 52

Licensing Medicaid Medicaid Malpractice 52

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

Physician Credentialing Company

SEPTEMBER 10, 2024

Provider credentialing is the process of evaluating the providers’ credentials, including medical degrees, training certificates, work history and licenses. You need to submit the application to the insurance companies along with all necessary documents. What is Provider Credentialing? It is not true for all companies.

Licensing 52

Licensing Malpractice Medical Billing Doctors 52

MedTrainer

OCTOBER 29, 2023

Physical License Only California currently provides physical licenses for practitioners. This wallet-size license requires holders to scan, photocopy, or take a picture for recredenialing or verification. Make it easy for providers to submit documents. Primary Source Verification. Work History and Reference Checks.

Licensing 52

Licensing Malpractice Medicaid Medicaid 52

Verisys

AUGUST 17, 2023

This helps guarantee that all practitioners in your organization meet the requisite licensing and certification requirements. Mitigating liability and legal risks Malpractice claims and legal disputes can financially and emotionally drain healthcare providers and organizations. Here at Verisys, we make credentialing easy.

Malpractice 52

Malpractice Licensing Compliance Medicaid 52

MedTrainer

JULY 10, 2023

Credentialing organizations verify that healthcare providers hold valid and unrestricted licenses to practice medicine and any additional certifications relevant to their specialties. This involves checking for any disciplinary actions, malpractice claims, or adverse events related to the provider’s practice. Peer references.

Malpractice 52

Malpractice Compliance Licensing Hospitals 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

MedTrainer

OCTOBER 29, 2023

The Colorado Medical Board oversees medical credentialing and licensing within the state. Controlled Substance Licensure Colorado has a one license requirement for controlled substance licensure. Revalidation every five years is required for providers to remain enrolled. Payers in Colorado have specific requirements. Background Checks.

Licensing 52

Licensing Malpractice Medicaid Medicaid 52

Physician Credentialing Company

JULY 23, 2024

If candidates get approved by the credentialing committee, they are presented with a medical practicing license to work in a specific healthcare department. This behavior can cause them to be charged with penalties and even confiscation of their hospital license. In case of any discrepancy, the application is rejected.

Hospitals 52

Hospitals Licensing Malpractice Doctors 52

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

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

NOVEMBER 27, 2023

The State Medical Board of Ohio provides licensing and regulatory guidelines for medical providers in Ohio State. The Counselor, Social Worker, and Marriage and Family Therapist Board oversees regulatory adherence and licensing for mental/behavioral health providers and social workers.

Compliance 52

Compliance Licensing Medicaid Medicaid 52

MedTrainer

APRIL 26, 2024

Primary source verification involves contacting original sources — such as educational institutions, licensing boards, and certification bodies — to confirm the authenticity and accuracy of the documents and qualifications provided by the provider. Make it easy for dentists to submit documents. Primary Source Verification.

Medicare 52

Medicare Medicare Licensing Malpractice 52

MedTrainer

MAY 15, 2024

Florida Medicaid Portal The Florida Medicaid Web Portal is very specific and if you aren’t familiar with submitting the documentation, it is easy to make a wrong turn. Comprehensive background checks help rule out any criminal history, malpractice claims, disciplinary actions, or other records that might raisesend up red flags.

Medicaid 52

Medicaid Medicaid Medicare Medicare 52

Verisys

JANUARY 11, 2022

The first documentation of medical credentialing can be traced to 1000 BC by the ancient Persian, Zoroaster, in which physician licensure was outlined in The Vendidad, the book of the law. I-9 documentation listed as List A or List B or List C as defined on the form. Malpractice history and hospital sanctions. Certificates.

Malpractice 52

Malpractice Licensing Health Insurance Hospitals 52

MedTrainer

FEBRUARY 29, 2024

Some examples of required information include the provider’s education, work history, licenses, and references. The organization should also obtain malpractice and liability insurance for the provider since all insurance companies require it. This typically involves gathering and verifying the provider’s information and credentials.

Malpractice 52

Malpractice Licensing Nurses Governance 52

MedTrainer

MAY 6, 2024

We’ll walk you through the steps to enroll providers with Aetna (a CVS Health company), the information and documents you’ll need, and best practices to follow. This blog will highlight how credentialers can navigate Aetna provider enrollment. Why Is Payer Enrollment Important For Healthcare Organizations?

Licensing 52

Licensing Malpractice Health Insurance Medicaid 52

MedTrainer

MAY 29, 2024

Primary source verification involves contacting original sources — such as educational institutions, licensing boards, and certification bodies — to confirm the authenticity and accuracy of the documents and qualifications provided by the provider. Make it easy for providers to submit documents. Primary Source Verification.

Medicaid 52

Medicaid Medicaid Malpractice Licensing 52

MedTrainer

JULY 10, 2023

Credentialing organizations verify that healthcare providers hold valid and unrestricted licenses to practice medicine and any additional certifications relevant to their specialties. This involves checking for any disciplinary actions, malpractice claims, or adverse events related to the provider’s practice. Peer references.

Malpractice 40

Malpractice Compliance Licensing Hospitals 40

Healthcare IT Today

NOVEMBER 13, 2024

For instance, Arizona demands a 10-year history of any sanctions on a provider’s license, while others ask about past malpractice suits. Adding to the complexity, some states require detailed historical information. The time frame for credentialing can be another significant obstacle.

Medicaid 66

Medicaid Medicaid Hospitals Malpractice 66

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. This can include résumés, licenses, diplomas, and insurance (payer) enrollments.

Licensing 52

Licensing Compliance Malpractice Hospitals 52

MedTrainer

MARCH 14, 2024

The specialist authenticates the provider’s education, work history, licenses, and other information during provider credentialing. Additionally, the credentialing specialist may request a record of any pending and past medical malpractice cases and disciplinary actions from the appropriate authority.

Malpractice 52

Malpractice Licensing Hospitals Compliance 52

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. Consider that any services a non-credentialed physician renders likely won’t be reimbursable by insurance companies.

Compliance 52

Compliance Regulatory Compliance Malpractice Licensing 52

MedTrainer

JULY 10, 2023

Even after someone goes through all the schooling, passes their medical boards and obtains a license to practice, physician credentialing still stands between a provider and patients — no matter where they are in their career. Malpractice history. It takes more than a medical degree to practice medicine. Board certification.

Malpractice 40

Malpractice Licensing Compliance Regulatory Compliance 40