The Health Law Firm Blog

JANUARY 24, 2023

Board Certified by The Florida Bar in Health Law In a possibly precedent-setting case, on November 9, 2022, for the first time, an appeals court in New Jersey ruled that plaintiffs in medical malpractice cases do not need an affidavit of merit to file claims against a [.] Indest III, J.D.,

Malpractice 52

Malpractice Overpayments Overpayment Licensing 52

MedTrainer

MARCH 30, 2024

Step-By-Step Provider Enrollment Process There are many reasons provider enrollments are delayed: incorrect information, missing documents, busy credentialers, and slow-moving payers. CAQH Profile Management Streamline your enrollment processes with the most up-to-date provider information at your fingertips.

Malpractice 98

Malpractice Licensing Medicaid Medicaid 98

MedTrainer

MAY 30, 2024

Compiling that volume of information for all of your organization’s providers is hard enough. Traditionally, credentialers call the appropriate entities to verify transcripts, licenses, etc. Data Accuracy and Verification : Verifying the accuracy of the information is crucial but challenging.

Licensing 52

Licensing Malpractice Medicare Medicare 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. Here is a list of the information you’ll need to gather for UnitedHealthcare credentialing: Training and Education Practitioner degree (M.D.,

Malpractice 52

Malpractice Licensing Medicaid Medicaid 52

Verisys

NOVEMBER 30, 2023

Credentialing lapses can expose a healthcare organization to malpractice suits and accreditation problems. All certifications and licenses must be verified for every provider who administers services to patients. The average physician enrollment application requires an overwhelming amount of information and data. Mistake No.

Malpractice 52

Malpractice Licensing Due Diligence Hospitals 52

Verisys

JULY 20, 2023

An organization must verify all certifications and licenses for every provider who administers patient services. 2: Having incomplete enrollment applications The average provider enrollment application requires an overwhelming amount of information and data. Mistake No. Mistake No. Mistake No. Mistake No. Mistake No. Mistake No.

Due Diligence 52

Due Diligence Malpractice Licensing Hospitals 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

Provider Trust

JULY 8, 2022

A holistic approach to exclusion monitoring and license verifications must include monitoring of disciplinary databases such as the National Practitioner Data Bank (NPDB). The National Practitioner Data Bank (NPDB) is a confidential information clearinghouse operated by the U.S. For more information, view the webinar on demand.

Licensing 52

Licensing Malpractice Fraud 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. They may require additional information or clarifications before granting approval. They may require additional information or clarifications before granting approval.

Malpractice 52

Malpractice Licensing Nurses Compliance 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

MARCH 23, 2024

Let’s review some key information that’s verified during credentialing and discuss examples of what could happen without medical credentialing. Key Information Medical Credentialing Verifies Most people think of healthcare providers as physicians, physician assistants, and other advanced practice professionals.

Licensing 52

Licensing Malpractice Governance Doctors 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. Once Cigna verifies the information on the credentials, the health plan credentialing committee will receive the application.

Malpractice 52

Malpractice Licensing Hospitals 52

MedTrainer

AUGUST 2, 2023

Thoroughly reviewing and verifying credentials helps organizations identify any gaps or issues that may pose risks to patient safety, such as expired licenses or malpractice claims. Fines, medical malpractice claims, and patient harm are concerns if credentialing isn’t properly managed. Risk Mitigation.

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Malpractice Compliance Licensing Due Diligence 97

The Health Law Firm Blog

MARCH 11, 2024

By: George F. Indest III, J.D., Board Certified by The Florida Bar in Health Law and Hartley Brooks, Law Clerk, The Health Law Firm On November 22, 2023, the Supreme Court of Pennsylvania unanimously decided that a serial killer cannot sue his psychiatrist for gross negligence because the action is barred by the [.]

Malpractice 52

Malpractice Licensing Nurses 52

The Health Law Firm Blog

FEBRUARY 6, 2024

By: George F. Indest III, J.D., Board Certified by The Florida Bar in Health Law and Hartley Brooks, Law Clerk, The Health Law Firm On November 22, 2023, the Supreme Court of Pennsylvania unanimously decided that a serial killer cannot sue his psychiatrist for gross negligence because the action is barred by the [.]

Malpractice 52

Malpractice Licensing Nurses 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. The process starts with the submission of detailed information about the provider’s credentials to the payer.

Malpractice 52

Malpractice Compliance Licensing Medical Billing 52

Verisys

FEBRUARY 4, 2022

Credentialing lapses can expose a healthcare organization to malpractice suits and accreditation problems. All certifications and licenses must be verified for every provider who administers services to patients. The average physician enrollment application requires an overwhelming amount of information and data. Mistake No.

Malpractice 52

Malpractice Licensing Due Diligence Hospitals 52

Verisys

AUGUST 17, 2023

Missing critical information in the credentialing process can significantly affect your organization. This helps guarantee that all practitioners in your organization meet the requisite licensing and certification requirements. Bottlenecks can pop up every step along the way, prolonging the process.

Malpractice 52

Malpractice Licensing Compliance Medicaid 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. Several factors, such as incorrect or missed information and high application volume, can extend the processing duration.

Malpractice 52

Malpractice Medicare Medicare Medicaid 52

Healthcare IT Today

NOVEMBER 13, 2024

Providers are often required to submit extensive personal information, including Social Security numbers, home addresses, and even fingerprints in some cases. 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

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.

Licensing 52

Licensing Compliance Malpractice Hospitals 52

Physician Credentialing Company

OCTOBER 25, 2024

In this article, we will discuss detailed information regarding what the 90834 CPT code means, who can assign it, and the services covered by it. For example, a psychotherapist who has a professional practicing license might embrace the cognitive-behavioral approach to urge the patient to overcome negative thinking methods.

Licensing 52

Licensing Medical Billing Telemedicine Medicare 52

Bill of Health

APRIL 4, 2024

The main federal health privacy law, the Health Insurance Portability and Accountability Act of 1996 (HIPAA) applies only to “covered entities” like health insurers, claims- processing clearinghouses, and health care providers and their business associates, and only to a subset of protected health care information.

FDA 288

FDA Malpractice Regulatory Compliance Health Insurance 288

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. Review and evaluation.

Malpractice 52

Malpractice Compliance Licensing Hospitals 52

MedTrainer

FEBRUARY 5, 2024

This process typically involves submitting an application with detailed information regarding the provider’s qualifications and licenses. Information about the employer’s Taxpayer Identification Number (TIN) , practice location, and protocol agreements are also needed.

Licensing 52

Licensing Governance Compliance Fraud 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. Obtain A CAQH Profile The Council for Affordable Quality Healthcare (CAQH) is an online portal that all insurance companies use to get providers’ information.

Licensing 52

Licensing Malpractice Medical Billing Doctors 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. Aetna systems will reflect your provider’s participation effective date, and Aetna members can see the provider’s information in the directory.

Licensing 52

Licensing Malpractice Health Insurance Medicaid 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. This includes personal information, education history, training, work experience, and professional references.

Licensing 52

Licensing Compliance Nurses Malpractice 52

MedTrainer

AUGUST 9, 2023

What Documents and Information Are Required? This form collects general information such as personal details, contact information, and professional background. Licenses and Certifications. Copies of all current and valid medical licenses, board certifications, and registrations must be submitted. Work History.

Malpractice 52

Malpractice Licensing 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. It can also save around 3 hours in administrative time manually entering information to complete the credentialing process.

Compliance 52

Compliance Regulatory Compliance Malpractice Licensing 52

MedTrainer

FEBRUARY 29, 2024

Here are the main insurance credentialing steps: Gather and Verify Provider Information: Before initiating the insurance credentialing process, healthcare organizations must first complete the provider credentialing process. This typically involves gathering and verifying the provider’s information and credentials.

Malpractice 52

Malpractice Licensing Nurses Governance 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. Review and evaluation.

Malpractice 40

Malpractice Compliance Licensing Hospitals 40

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. Work history. References.

Malpractice 40

Malpractice Licensing Compliance Regulatory Compliance 40

MedTrainer

APRIL 27, 2024

The visit usually lasts three days, during which the surveyor will meet with center leaders and board members to gather information and assess compliance. Verification of current licensure, registration, or certification Primary source verification (PSV) directly from the state licensing agency/body.

Licensing 52

Licensing Compliance Malpractice Governance 52

MedTrainer

OCTOBER 26, 2023

In a nutshell, CAQH serves as a central hub where healthcare providers can submit and update all their professional information. Since providers are updating and attesting information in one place, entities can be confident they have the most updated demographic and professional information.

Licensing 52

Licensing Malpractice Hospitals 52

Verisys

JANUARY 11, 2022

These must include issuing state, license type, license number, status, and issue and expiration dates. Healthcare-specific information on state/federal criminal convictions or civil judgments. Malpractice history and hospital sanctions. Malpractice Insurance. Accurate, compliant, and complete information.

Malpractice 52

Malpractice Licensing Health Insurance Hospitals 52

MedTrainer

MAY 15, 2024

Annual Updates Most of the New York organizations that my team works with ask for NPDB (National Practitioner Data Bank) reports, background checks, malpractice insurance information, and more. An this is information that is completed annually. Like I said, medical credentialing services in New York go the extra mile. 3.

Malpractice 52

Malpractice Medicaid Medicaid Licensing 52