Physician Credentialing Company

DECEMBER 9, 2024

Along with having necessary educational degrees and medical licenses, maintaining such credentials is also important and comes under credentialing. Generally, credentialing specialists verify the educational degrees, medical licenses, experience certificates, and training programs. What do we mean by maintaining credentials here?

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Malpractice Licensing Compliance Regulatory Compliance 52

Physician Credentialing Company

JUNE 12, 2024

You will need to gather and submit documents such as your medical license, malpractice insurance, and board certifications. Key Documents Required Medical license Board certifications Malpractice insurance Malpractice insurance Completing these steps correctly is crucial for a smooth credentialing experience.

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Malpractice Licensing Nurses Compliance 52

MedTrainer

MAY 7, 2024

We’ll walk you through the steps in enrolling your providers with UnitedHealthcare, the information and documents you need, and the best practices to follow. This blog will highlight how credentialers can navigate UnitedHealthcare provider enrollment. Why Is Payer Enrollment Important for Healthcare Providers?

Malpractice 52

Malpractice Licensing Medicaid Medicaid 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.

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Doctors Malpractice Licensing Medical Billing Outsourcing 52

HIT Consultant

SEPTEMBER 19, 2021

According to CRICO’s national CBS Database, 66% of malpractice cases in telemedicine from 2014 to 2018 were connected to misdiagnosis. Particularly the certification and license are one of the main challenges for nurses in telemedicine. Pandemic allowed those who were hesitant to try out telemedicine. Misdiagnoses. On-demand nursing.

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Telemedicine Licensing Nurses HIPAA 98

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.

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Malpractice Licensing Hospitals 52

Physician Credentialing Company

NOVEMBER 21, 2024

We will also discuss the documents needed and various credentialing challenges. Insurance credentialing is the verification process in which credentials like educational degrees, licenses, training certificates, and work experience are evaluated to determine whether a specific provider can provide standard care to insured patients or not.

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Licensing Malpractice Medicaid Medicaid 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.

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Licensing Compliance Malpractice Hospitals 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.

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Licensing Compliance Malpractice Governance 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.

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Malpractice Compliance Licensing Medical Billing 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.

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Malpractice Licensing Compliance 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.

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Malpractice Licensing Health Insurance Hospitals 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.

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Licensing Malpractice Governance Doctors 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.

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Malpractice Licensing Compliance Medicaid 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.

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Malpractice Medicaid Medicaid Licensing 52

MedTrainer

JULY 28, 2023

This ensures that medical facilities are not engaging in malpractice and following program rules and regulations. Run exclusion checks regularly and document the results. Medicare/Medicaid Compliance Reviews. The OIG performs regular compliance reviews of Medicare and Medicaid providers. What Is the Scope of an OIG Inspection?

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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.

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Malpractice Licensing Due Diligence Compliance 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

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.

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Licensing Malpractice Medicaid 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.

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Licensing Medicaid Medicaid Malpractice 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.

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Licensing Medicaid Medicaid Malpractice 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.

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Medicare Medicare Licensing Compliance 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.

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Licensing Compliance Nurses Malpractice 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. Who can Bill CPT Code 90834?

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Licensing Medical Billing Telemedicine Medicare 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!

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Licensing Malpractice 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.

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Licensing Malpractice 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

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.

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Compliance Licensing Medicaid Medicaid 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.

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Malpractice Licensing Nurses Governance 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.

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Malpractice Medicare Medicare Medicaid 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.

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Malpractice Fraud Licensing Compliance 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.

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Hospitals Licensing Malpractice Doctors 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.

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Medicaid Medicaid Medicare Medicare 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.

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Licensing Malpractice Medical Billing Doctors 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. This can include résumés, licenses, diplomas, and insurance (payer) enrollments.

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Licensing Compliance Malpractice Hospitals 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

Medisys Compliance

OCTOBER 30, 2023

Here are the general steps involved: Gather Required Documents: Collect all the necessary documents, such as your professional license, certifications, malpractice insurance, and practice information. Submit Applications: Send the completed applications along with the required documents to the insurance companies.

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Medical Billing Outsourcing Medical Billing Malpractice Licensing 59