MedTrainer

MARCH 22, 2024

In this blog, we’ll highlight how to navigate Cigna provider enrollment. Here are the key steps: Gather Training and Education Gather Licensing and Certification Gather Work History Details Gather Payer-Specific Requirements Following Application Submission Get the tools you need to eliminate delays in your provider enrollment process.

Malpractice 52

Malpractice Licensing Hospitals 52

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

MARCH 26, 2024

By George F. Indest III, J.D., Board Certified by The Florida Bar in Health Law On September 29, 2021, the U.S. Court of Appeals for the Ninth Circuit ruled that a former federal employee can sue the United States under the Federal Tort Claims Act (FTCA). The suit alleges medical negligence that occurred [.]

Malpractice 52

Malpractice Nurses Hospitals Licensing 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

MedTrainer

APRIL 27, 2024

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. Primary source verification (PSV) directly from the state licensing or certification agency/body.

Licensing 52

Licensing Compliance Malpractice Governance 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.

Licensing 52

Licensing Malpractice Governance Nurses 52

Verisys

JULY 20, 2023

An organization must verify all certifications and licenses for every provider who administers patient services. 4: Not updating and verifying information Healthcare practitioners need to renew their licenses and credentials on a regular basis, according to federal and state laws. Mistake No. Mistake No. Mistake No. Mistake No.

Due Diligence 52

Due Diligence Malpractice Licensing Hospitals 52

The Health Law Firm Blog

SEPTEMBER 6, 2023

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 July 18, 2023, a federal judge in North Carolina granted a motion to dismiss a suit against Naval Hospital Camp Lejeune based on a state law four-year time [.]

Malpractice 52

Malpractice Hospitals Licensing Nurses 52

MedTrainer

FEBRUARY 5, 2024

In this blog, we’ll discuss the two processes and key differences between provider enrollment and credentialing. This process typically involves submitting an application with detailed information regarding the provider’s qualifications and licenses. The information confirms a provider is currently licensed to practice medicine.

Licensing 52

Licensing Governance Compliance Fraud 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). Department of Health and Human Services (HHS) and contains medical malpractice payments and adverse action reports on healthcare professionals.

Licensing 52

Licensing Malpractice Fraud Compliance 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.

Malpractice 52

Malpractice Licensing Compliance Medicaid 52

MedTrainer

FEBRUARY 29, 2024

In this blog, we’ll review insurance credentialing and the steps to getting credentialed with insurance companies. Some examples of required information include the provider’s education, work history, licenses, and references. There are several steps to this time-consuming process. What is Insurance Credentialing?

Malpractice 52

Malpractice Licensing Nurses Governance 52

MedTrainer

APRIL 18, 2024

In this blog post, we’ll explore these and how behavioral health practices are adopting technology to prepare for the future. This may include proof of licensure, certification, accreditation, malpractice insurance, DEA registration (if applicable), and other supporting documentation.

Medicare 52

Medicare Medicare Licensing Compliance 52

McBrayer Law Blog

SEPTEMBER 19, 2022

Often, these procedures require the supervision of a licensed physician or nurse practitioner, creating a unique regulatory issue.

Malpractice 52

Malpractice Nurses Licensing 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. Review and evaluation.

Malpractice 52

Malpractice Compliance Licensing Hospitals 52

MedTrainer

SEPTEMBER 20, 2023

Legal costs, settlements, and increased malpractice insurance premiums can put financial burdens on ASCs found guilty of negligent credentialing. This process should include comprehensive checks of education, training, licensure, malpractice history, and any disciplinary actions. Financial Consequences. Long-Term Consequences.

Malpractice 52

Malpractice Licensing Due Diligence Compliance 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. Delays in this process can delay providers’ ability to practice in the ASC.

Licensing 52

Licensing Malpractice Compliance 52

The Health Law Firm Blog

DECEMBER 31, 2022

By George F. Indest III, J.D., Board Certified by The Florida Bar in Health Law On September 29, 2021, the U.S. Court of Appeals for the Ninth Circuit ruled that a former federal employee can sue the United States under the Federal Tort Claims Act (FTCA). The suit alleges medical negligence that occurred [.].

Malpractice 40

Malpractice Nurses Hospitals Licensing 40

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. If the dentist is being credentialed in a state with its own portal, set that up as well.

Medicare 52

Medicare Medicare Malpractice Licensing 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.

Compliance 52

Compliance Licensing Medicaid Medicaid 52

MedTrainer

MARCH 14, 2024

The specialist authenticates the provider’s education, work history, licenses, and other information during provider credentialing. Additionally, the credentialing specialist may request a record of any pending and past medical malpractice cases and disciplinary actions from the appropriate authority.

Malpractice 52

Malpractice Licensing Hospitals Compliance 52

MedTrainer

AUGUST 9, 2023

Licenses and Certifications. Copies of all current and valid medical licenses, board certifications, and registrations must be submitted. Malpractice Insurance. Providers must show proof of malpractice insurance coverage or liability insurance to begin practicing. Work History. References. DEA Registration.

Malpractice 52

Malpractice Licensing Compliance 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.

Licensing 52

Licensing Medicaid Medicaid Malpractice 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. It can take as long as four to five months to credential a new provider simply because of this backlog. Background Checks.

Licensing 52

Licensing Malpractice Medicaid Medicaid 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. Primary Source Verification. Background Checks. Payer Enrollment.

Licensing 52

Licensing Malpractice Medicaid Medicaid 52

Provider Trust

APRIL 14, 2023

When a healthcare provider or organization bills a payer for services rendered, payers need up-to-date credentialing data to ensure these providers are properly licensed to give expert clinical services. Additionally, disparate primary source data can be outdated and/or incomplete and often disconnected across state lines.

Licensing 52

Licensing Compliance Malpractice Medicaid 52

Hall Render

DECEMBER 12, 2023

CMS stated that this could include any misdemeanor that places the Medicare program or its beneficiaries at immediate risk, such as a malpractice suit that results in a conviction of criminal neglect or misconduct. Hall Render blog posts and articles are intended for informational purposes only.

Medicare 40

Medicare Medicare Licensing Malpractice 40

MedTrainer

JULY 28, 2023

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

Fraud 98

Fraud Compliance Medicaid Medicaid 98

Verisys

DECEMBER 5, 2023

State licensing boards verify practitioner license type and status. The policy issuer for malpractice insurance verifies insurance coverage. Because they have first-hand knowledge, these primary sources can confirm if the information claimed is accurate. Here are some examples: Medical schools verify completion of education.

Governance 52

Governance Licensing Malpractice Medicaid 52

MedTrainer

FEBRUARY 13, 2022

By ensuring that healthcare providers have the proper license and documentation to provide treatment, they are safeguarding the health and wellbeing of their patients as well as protecting the facility from potential liabilities. Licensing Requirements: Ensuring that the healthcare professional has the proper licensing to practice medicine.

Licensing 40

Licensing Malpractice Governance Compliance 40

Pharmacy Law Blog

APRIL 30, 2018

If you are a physician, nurse practitioner, psychologist, clinical pharmacist, oral surgeon, ophthalmologist, or other licensed health professional with clinical privileges in a hospital, chances are that one day you will be subject to a peer review action or investigation. This is part 1 of a 2 part blog series. Indest III, J.D.,

Hospitals 52

Hospitals Nurses Malpractice Nursing Homes 52

Verisys

DECEMBER 1, 2023

Verisys is certified in the following areas: Medical Board Sanctions Medicare/Medicaid Sanctions Ongoing Monitoring of Sanctions License to Practice DEA Certification Application Processing Education and Training Malpractice Claims History Work History CVO Application and Attestation Content Board Certification Status As an NCQA certified organization, (..)

Medicaid 52

Medicaid Medicaid Medicare Medicare 52

MedTrainer

AUGUST 2, 2023

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. Primary Source Verification. Background Checks.

Due Diligence 52

Due Diligence Malpractice Licensing Compliance 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. This creates the potential for negative patient outcomes, which can lead to expensive malpractice lawsuits.

Malpractice 52

Malpractice Licensing Due Diligence 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.

Malpractice 97

Malpractice Compliance Licensing Due Diligence 97

The Health Law Firm Blog

SEPTEMBER 28, 2023

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 June 21, 2023, the Iowa Court of Appeals overturned the verdict in a nursing home negligence case that awarded $6 million in compensation and damages to the plaintiff. [.]

Nursing Homes 52

Nursing Homes Nurses Health Care Lawyers Malpractice 52

The Health Law Firm Blog

AUGUST 29, 2023

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 June 21, 2023, the Iowa Court of Appeals overturned the verdict in a nursing home negligence case that awarded $6 million in compensation and damages to the plaintiff. [.]

Nursing Homes 52

Nursing Homes Nurses Health Care Lawyers Malpractice 52