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Are Provider Enrollment and Credentialing the Same?

MedTrainer

In this blog, we’ll discuss the two processes and key differences between provider enrollment and credentialing. Provider enrollment is when a healthcare provider is registered with insurance networks or government payers , like Medicaid or Medicare. So, what is the difference between provider enrollment and credentialing?

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7 Examples of What Could Happen Without Medical Credentialing

MedTrainer

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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Aetna Provider Enrollment: What To Expect

MedTrainer

This blog will highlight how credentialers can navigate Aetna provider enrollment. Built-in Automation: Keep the enrollment process moving forward with automated reminders for providers to send documents, notification of recredentialing deadlines, and license expiration.

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HRSA Credentialing: Master the Operational Site Visit

MedTrainer

In this blog, we’ll look at the unique aspects of HRSA credentialing requirements and why many community health centers, FQHCs , and look-alikes use credentialing software to prepare for a successful on-site visit. Government-issued picture identification. Keeping these straight in a very fast-paced healthcare environment is tough!

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Quick Guide to the National Practitioner Data Bank (NPDB)

Provider Trust

A holistic approach to exclusion monitoring and license verifications must include monitoring of disciplinary databases such as the National Practitioner Data Bank (NPDB). Department of Health and Human Services (HHS) and contains medical malpractice payments and adverse action reports on healthcare professionals.

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Primary Source Verification: One of the Hidden Secrets to Ensuring Excellence in Any Healthcare Organization

Verisys

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.

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Getting Credentialed with Insurance Companies

MedTrainer

In this blog, we’ll review insurance credentialing and the steps to getting credentialed with insurance companies. The insurance credentialing process is when a healthcare organization registers a provider through specific insurance carriers or government payers. There are several steps to this time-consuming process.