MedTrainer

FEBRUARY 5, 2024

Provider enrollment is when a healthcare provider is registered with insurance networks or government payers , like Medicaid or Medicare. This process typically involves submitting an application with detailed information regarding the provider’s qualifications and licenses. What is Provider Credentialing?

Licensing 52

Licensing Governance Compliance Fraud 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

AIHC

SEPTEMBER 5, 2023

Compliance Considerations for Best Outcomes Written in collaboration with the AIHC Volunteer Education Committee Delivering mental health services via telehealth has increased since the COVID-19 pandemic. Medicare covers many telebehavioral and telemental health services including audio-only services.

COVID-19 59

COVID-19 Telemedicine Compliance Informed Consent 59

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. Regardless of your approach, the credentialing process can be quite complex.

Licensing 52

Licensing Compliance Malpractice Medicaid 52

Verisys

JANUARY 19, 2022

According to recent surveys of major metropolitan hospitals , departments that typically share the responsibility for credentialing include: The Compliance Office. Checks credentialing for Health Insurance Portability and Accountability Act (HIPAA) compliance. Ensures proper credentialing and privileging of the licensed medical staff.

US Department of Health and Human Services 52

US Department of Health and Human Services Hospitals Malpractice Compliance Officers 52

Medisys Compliance

MARCH 27, 2023

These terminologies are briefly discussed below for better understanding: Provider enrollment: This refers to the process of enrolling a healthcare provider with an insurance plan or government program, such as Medicare or Medicaid. By meeting these requirements, providers can expand their patient base and increase revenue.

Malpractice 52

Malpractice Medical Billing Outsourcing Governance Patient Satisfaction 52

Verisys

DECEMBER 1, 2023

It allows organizations to stay compliant with state and federal requirements and maintains their accreditation with Medicare, Medicaid, TRICARE, and other programs. As a CVO that has achieved this certification, Verisys can give partner organizations peace of mind that it is meeting the rigorous compliance standards set forth by NCQA.

Medicaid 52

Medicaid Medicaid Medicare Medicare 52

Verisys

DECEMBER 5, 2023

State licensing boards verify practitioner license type and status. The Centers for Medicare & Medicaid Services (CMS) Medicare and state Medicaid lists show practitioners who have opted out of those programs. The policy issuer for malpractice insurance verifies insurance coverage. And the list goes on.…

Governance 52

Governance Licensing Malpractice Medicaid 52

Medisys Compliance

OCTOBER 30, 2023

Compliance: Proper credentialing and billing are essential for remaining compliant with state and federal regulations , avoiding legal issues, and protecting the practitioner’s reputation. Financial Stability: Accurate and timely billing is crucial to a solo practitioner’s financial stability.

Medical Billing Outsourcing 59

Medical Billing Outsourcing Medical Billing Malpractice Licensing 59

Verisys

DECEMBER 23, 2021

Medicare, Medicaid, and TRICARE: How Enrollment Standards Differ. Provider enrollment in Medicare, Medicaid, TRICARE, and other government health programs all involve a lengthy process, with some variation. The following items are required for enrollment in Medicare: A primary place of service must be in operation.

Medicare 52

Medicare Medicare Medicaid Medicaid 52

Verisys

MARCH 1, 2022

State licensing boards verify practitioner license type and status. The Centers for Medicare & Medicaid Services (CMS) Medicare and state Medicaid lists show practitioners who have opted out of those programs. The policy issuer for malpractice insurance verifies insurance coverage. And the list goes on.…

Governance 52

Governance Licensing Malpractice Medicaid 52

AIHC

APRIL 25, 2022

Written by: Joanne Byron , BS, LPN, CCA, CHA, CHCO, CHBS, CHCM, CIFHA, CMDP, COCAS, CORCM, OHCC, ICDCT-CM/PCS This article addresses how to track telehealth policies while addressing HIPAA compliance and mobile device management as the United States enters into a post-pandemic era. What Additional Information Should I Know for Compliance?

HIPAA 52

HIPAA Compliance COVID-19 Compliance Officers 52

HIT Consultant

FEBRUARY 5, 2024

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 96

Malpractice Licensing Due Diligence Hospitals 96

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

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. 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

It involves collecting and reviewing information such as education, training, licensure, certifications, work history, malpractice history, and references — all in pursuit of verifying that providers are who they say they are and qualified to deliver legitimate, safe, and ethical care. Why Is Provider Credentialing Important?

Malpractice 52

Malpractice Due Diligence Compliance Licensing 52

Hall Render

JUNE 10, 2022

These are the compliance issues providers should be preparing for, post-PHE. Medical malpractice trends in Northwest Arkansas. Florida hospital offers to discharge alleged malpractice victim’s bills in exchange for silence, daughter says. New Hampshire hospital leaders’ licenses suspended amid probe of missing fentanyl.

COVID-19 40

COVID-19 Nursing Homes Nurses Hospitals 40

Medisys Compliance

MARCH 23, 2023

Provider credentialing involves verifying and evaluating the mental health provider’s education, training, certification, and licensing to ensure that they meet the standards and criteria of the insurance company, regulatory bodies, and other organizations.

Medical Billing Outsourcing 52

Medical Billing Outsourcing Medical Billing Malpractice Health Insurance 52

Verisys

APRIL 7, 2023

Most hospitals use the Office of Inspector General’s List of Excluded Individuals and Entities ( OIG-LEIE ) for primary source verification, which consists of current providers and entities excluded from participating in all federal healthcare programs like Medicaid or Medicare.

Licensing 52

Licensing Malpractice Hospitals Medicaid 52

Verisys

APRIL 27, 2023

If an application is missing key pieces, such as a scan through a primary source or a copy of their license, table the application. Our solutions are fully accredited by NCQA and URAC, allowing us to maintain the industry’s highest data and compliance standards. Only review files with complete applications.

Malpractice 52

Malpractice Licensing Fraud Medicaid 52

Hall Render

JUNE 30, 2023

MedStar Transport Celebrates 40 years of service C.

US Department of Health and Human Services 40

US Department of Health and Human Services Nursing Homes Nurses Hospitals 40

Hall Render

SEPTEMBER 23, 2022

Healthcare Compliance Will Be a Challenge in Post-PHE World. Aspen U surrenders nursing program license. Aspen University in Phoenix surrenders nursing program license, failing to meet NCLEX first-time pass rate. Colorado senior-care company pauses expansion into Indiana after Medicare audit. Intermountain St.

COVID-19 40

COVID-19 Nurses Nursing Homes Hospitals 40

Hall Render

MARCH 3, 2023

million for youth mental health care KENTUCKY Pike County nursing home officials release statement following loss of Medicare agreement Three Humana executives drop $11.2M million for youth mental health care KENTUCKY Pike County nursing home officials release statement following loss of Medicare agreement Three Humana executives drop $11.2M

Nursing Homes 40

Nursing Homes COVID-19 Nurses Hospitals 40

Hall Render

FEBRUARY 24, 2023

medical workers 4 takeaways from Braselton hospital expansion presentation HAWAII Hawaii Gov. Staff shortages could spur next public health crisis, Baystate Health CEO warns CommonSpirit, Mass General, Moffitt execs to judge telehealth challenge Brigham and Women’s, AI company get $2.5M

Nursing Homes 40

Nursing Homes COVID-19 Nurses Hospitals 40

Hall Render

AUGUST 11, 2023

healthcare company keeps expanding How Mount Sinai uses AI to predict death risk Catholic Health opens New York ASC Report highlights maternal health care disparities in New York Local hospitals to see massive Medicare payment increase. Change in calculations will bring $10 million more in payments to NFMMC and Mount St. Mary’s.

US Department of Health and Human Services 40

US Department of Health and Human Services COVID-19 Nursing Homes Nurses 40

Hall Render

JULY 21, 2023

gives nod to 39 new medical cannabis businesses seeking a license Rose Health founder Kavi Misri launches new venture to help employers keep workers healthy 6 people hit by car in D.C. Million St. Here are arguments for and against. hospital parking garage Arlington named ‘America’s fittest city’ DC ranked No. 11th in mental health, No.

US Department of Health and Human Services 40

US Department of Health and Human Services Nurses Hospitals Nursing Homes 40