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What Is Physician Credentialing?

Verisys

This includes verifying education, residency, employment history, malpractice insurance, hospital privileges, and board certifications. It plays a key role in reducing malpractice risks, preventing fraud, and verifying that healthcare professionals have the necessary training and clinical experience to perform their duties.

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How To Prepare for an OIG Inspection

MedTrainer

Earlier this year, an in-depth OIG investigation resulted in a six-day trial of a former Louisiana health clinic CEO , who was ultimately convicted of Medicaid fraud and sentenced to 82 months in federal prison. This ensures that medical facilities are not engaging in malpractice and following program rules and regulations.

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What Is Physician Credentialing?

Verisys

This includes verifying education, residency, employment history, malpractice insurance, hospital privileges, and board certifications. It plays a key role in reducing malpractice risks, preventing fraud, and verifying that healthcare professionals have the necessary training and clinical experience to perform their duties.

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Quick Guide to the National Practitioner Data Bank (NPDB)

Provider Trust

In this quick guide, we’ll explore the importance of including NPDB monitoring in your routine license and exclusion monitoring to protect your organization and the patients you serve from fraud, waste, and abuse. Its mission is to enhance healthcare quality, defend the public, and decrease healthcare fraud and misuse in the U.S.

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5 Ways to Improve Your Credentialing Committee Meetings

Verisys

Start with quality data As a first step, pre-screening all applicants ensures that only viable applicants are presented to the credentials committee for review. Verisys’ proprietary dataset, Fraud Abuse Control Information System (FACIS) , is the largest and most comprehensive dataset for screening allied health and medical providers.

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Private Equity: Investigation and Enforcement

Med Law Blog

As you might expect from a federal investigation, conducted by politicians with media present, the tone of the meeting was more hostile rather than supportive. In March 2023, the House Ways and Means Committee hosted an investigative hearing on “private equity’s expanded role in the US healthcare system”.

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Introduction to Telebehavioral Health

AIHC

The lack of multistate licensure presents a barrier to telehealth because providers must obtain and uphold licensure (and the associated medical education and financial obligations) in multiple states. This includes understanding various fraud and abuse laws.