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8 Common Provider Credentialing Mistakes and How to Avoid Them

Verisys

An organization must verify all certifications and licenses for every provider who administers patient services. 3: Allowing a physician to treat patients before credentialing is completed Courts have held hospitals liable when a physician falsifies credentials, and the hospital fails to do its due diligence in verifying them.

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How HHS-OIG, Regulators Enforce Vendor Compliance

Provider Trust

Additionally, check out this HHS-OIG 2016 report, Medicare: Vulnerabilities Related to Provider Enrollment and Ownership Disclosure , which revealed “vulnerabilities that could allow potentially fraudulent providers to enroll in the Medicare program.”. Recent cases of OIG enforcement and other fines, penalties related to vendors.

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What Is Provider Credentialing?

MedTrainer

Listen to a candid discussion on lessons learned from the 2023 federal investigation that uncovered fraudulent medical practice nationwide in this on-demand webinar: Moving Forward From the Nursing Fraud Scheme. Primary source verification is done by contacting educational institutions, licensing boards, and other relevant authorities.