Provider Trust

MARCH 16, 2022

We often get asked the same clarifying questions – Are all exclusions created equal? Does it matter where an exclusion originated, or which agency issued it? Do exclusions differ across databases? So how do the datasets actually differ? What is an exclusion and how does it affect your organization?

Medicaid 52

Medicaid Medicaid Medicare Medicare 52

MedTrainer

AUGUST 15, 2022

But what does exclusion mean, and how does an organization determine it? For more information on this important subject, here’s an overview of exclusion database monitoring. What Is Healthcare Exclusion? Are you familiar with the Office of Inspector General (OIG)? But why would exclusions exist in the first place?

Compliance 52

Compliance Medicaid Medicaid Medicare 52

Verisys

DECEMBER 8, 2022

A professional career can take a provider across state lines, and through an evolution of various license types. In order to see the full picture of an individual, the comprehensive whole of each state licensing board across all license types must be searched. This either doesn’t happen in a timely manner, or doesn’t happen at all.

Licensing 52

Licensing Medicaid Medicaid Fraud 52

MedTrainer

NOVEMBER 15, 2023

Physician credentialing , also known as provider credentialing, can mean different things depending on the role of the person using the term and its context. Exclusions Monitoring: Regular checks of OIG-LEIE, SAM, and state exclusionary databases is essential for ensuring providers are qualified to practice.

Medicaid 52

Medicaid Medicaid Doctors Medicare 52

Provider Trust

SEPTEMBER 29, 2022

A 49-year-old Brownsville, TX man named Fernando Mendez was taken into custody in early September after being charged with defrauding Medicaid. From August 2021 to February 2022, Mendez provided patient assessments and evaluations and ordered treatments and prescriptions, all while billing Medicaid for his services.

Licensing 52

Licensing Fraud Medicaid Medicaid 52