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Each type of credentialing plays a vital role in maintaining high standards of patient care, ensuring regulatorycompliance, and promoting operational efficiency in healthcare settings. This duediligence can significantly reduce malpractice claims risk and protect patients and institutions.
By maintaining a robust compliance program, healthcare companies are better able to identify potential red flags early and to prevent violations of fraud and abuse laws. The GCPG provides voluntary, non-binding guidance to assist all individuals and entities in the healthcare industry to develop and maintain a successful compliance program.
Legal and RegulatoryCompliance Healthcare facilities and insurance companies are legally obligated to credential providers before allowing them to practice or join their networks. Selecting a credentialing provider takes a fair amount of duediligence; however, it’s time and energy that pay for themselves in short order.
Thus, she emphasized that “if a cooperating company discovers hot documents or evidence [during a government investigation], its first reaction should be to notify the prosecutors.”. Additionally, DOJ now will “require cooperating companies to come forward with important evidence” to prosecutors “more quickly.”
Additionally, and as we touched upon in our January 7, 2021 post on the No Surprises Act , these new measures supplement state laws governing surprise medical billing, and so in cases where a state No Surprises law applies, the state law generally determines an individual’s OON payment rate. [1]. 2] See 86 Fed.
Third-Party Vendor Assessment: Duediligence is required to thoroughly vet third-party vendors and their cybersecurity practices. About Britton Burton Britton Burton is the Senior Director of TPRM Strategy with its sister company, CORL Technologies , tech-enabled managed services for vendor risk management and compliance.
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