This site uses cookies to improve your experience. To help us insure we adhere to various privacy regulations, please select your country/region of residence. If you do not select a country, we will assume you are from the United States. Select your Cookie Settings or view our Privacy Policy and Terms of Use.
Cookie Settings
Cookies and similar technologies are used on this website for proper function of the website, for tracking performance analytics and for marketing purposes. We and some of our third-party providers may use cookie data for various purposes. Please review the cookie settings below and choose your preference.
Used for the proper function of the website
Used for monitoring website traffic and interactions
Cookie Settings
Cookies and similar technologies are used on this website for proper function of the website, for tracking performance analytics and for marketing purposes. We and some of our third-party providers may use cookie data for various purposes. Please review the cookie settings below and choose your preference.
Strictly Necessary: Used for the proper function of the website
Performance/Analytics: Used for monitoring website traffic and interactions
Malpractice Payments : Tracks settlements or judgments related to provider malpractice. Exclusion Checks : Lists providers barred from participating in federal (Medicare) or state (Medicaid) healthcare programs. The NPDB strictly focuses on misconduct and adverse event data, making it an indispensable tool for risk management.
It’s also a requirement of federal payers like Medicare, Medicaid, and private insurance companies. In addition, there can be other indirect costs, such as rising malpractice insurance costs and associated fiscal penalties. The cost of poor medical credentialing is estimated to exceed $36,000 per bed.
By verifying a doctor’s credentials, insurance companies can mitigate the risk of malpractice claims and ensure patient safety. Verification of Malpractice Insurance The fourth step in the credentialing process is to verify that the doctor has malpractice insurance.
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.
The Centers for Medicare and Medicaid Services (CMS) established credentialing by proxy as a way for telehealth practitioners to save time and money during the credentialing process. They must also share any complaints or adverse events regarding the practitioner with the distant site.
Ongoing Process: Privileging is not a one-time event. Proper privileging documentation is also critical to meet the standards of regulatory bodies such as the Centers for Medicare and Medicaid Services ( CMS ) and the National Committee for Quality Assurance ( NCQA ).
Reduce Adverse Events: Additional exclusions monitoring requirements promote faster action to prevent unintended patient incidents or quality issues. This includes all credential types: license to practice, board certification, work history, malpractice history, state licensing sanctions, and both Medicare/Medicaid sanctions and exclusions.
Healthcare organizations must ensure their providers meet strict standards set by accrediting bodies like The Joint Commission (TJC) and the National Committee for Quality Assurance (NCQA) , as well as state medical boards and federal agencies such as the Centers for Medicare & Medicaid Services (CMS ).
Go out and attend those events, whether it is charity or a meet and greet in your town. For companies that fall under the regulation of billing Medicare and Medicaid, which are not under a medical exemption, they will need to be Accredited by an approved Accreditation Organization.
While we can’t change the past, we can learn from it to prevent future events like this from happening. Getting real-time sanction and exclusion updates allows you to act before adverse events occur in your organization. As you learn more about his story, you may ask how something like this could happen.
1 for flu in the U.S., expert says RSV is off the charts Ochsner Health named to U.S. United Therapeutics ‘no longer pursuing’ nearly 350 acres in Hackett Hill area NEW JERSEY 4 N.J. in Q3 Mergers give hospitals new EHR systems N.J. nursing home scam highlights host of problems | Editorial North Jersey Physical Therapy takes 1,800 sq.
to UConn cardiology center UConn gene discovery moves closer to treating neuromuscular disease, holds promise for weight loss DC D.C. to UConn cardiology center UConn gene discovery moves closer to treating neuromuscular disease, holds promise for weight loss DC D.C.
Tammany Health System create new residency program CHRISTUS nationally recognized for high-quality heart care Behind Ochsner LSU Health’s multimillion-dollar tech upgrades MAINE Millinocket hospital schedules renovation after $3.5M medical school to revamp philanthropic efforts Sage Health opening 3 central Md.
Tammany Health System create new residency program CHRISTUS nationally recognized for high-quality heart care Behind Ochsner LSU Health’s multimillion-dollar tech upgrades MAINE Millinocket hospital schedules renovation after $3.5M medical school to revamp philanthropic efforts Sage Health opening 3 central Md.
Alabama Medicaid enrollment increases as pandemic requirement continues. California to increase awards in medical malpractice cases. in malpractice case. Owners Of Behavioral Health Companies Sentenced For Medicaid Fraud. Pandemic uncertainty complicates Medicaid budget. Family nurse practitioners. Here’s why.
New mental health clinic in Rexburg accepts Medicaid and Medicare ILLINOIS 3 IL Children’s Hospitals Among Nation’s Best: U.S. Now, it’s against funding clinics missing standards. are among the nation’s highest. grant Sanford Health to build pediatric emergency department with lead gift from David H.
Children’s National Hospital hosts prom for patients battling illnesses Unfair labor complaints filed against George Washington University Hospital as nurses try to unionize DELAWARE ChristianaCare spin-out named ‘Most Promising New Company’ at Delaware Bio pitch event Delaware among states that struggle to provide nursing home oversight.
with more than 5 Magnet designations Four more years: Anthem Blue Cross and Blue Shield, Wellstar re-up contract Hospital fails to dodge $10M malpractice verdict after attempting to pin payment on radiologist New survey reveals insight into Georgia’s maternal health crisis New chief medical officer hired for St.
Medicaid fraud scheme Union leaders say payroll problems persist for home care workers CT universities embrace holistic care as a way to teach the new generation of health care workers Thousands of CT residents to lose HUSKY coverage, health group says. Therapist pleads guilty to $1.6M Therapist pleads guilty to $1.6M
Medicaid fraud scheme Union leaders say payroll problems persist for home care workers CT universities embrace holistic care as a way to teach the new generation of health care workers Thousands of CT residents to lose HUSKY coverage, health group says. Therapist pleads guilty to $1.6M Therapist pleads guilty to $1.6M
million to combat lack of health care providers in rural communities ‘Conscience’ bills let medical providers opt out of providing a wide range of care St. Attendees took notice.
Reeves doesn’t mention Medicaid expansion or health care crisis in State of the State address U.S. KXAN investigates Does UT Tyler Health Science Center’s deal with private equity shield doctors from malpractice suits? R1 RCM posts $3.3M R1 RCM posts $3.3M
Dunleavy proposes extending Medicaid coverage for new mothers ARIZONA Banner Health pays $1.25M penalty over HIPAA failures from 2016 breach Arizona nursing school at risk of losing accreditation St. billion since pandemic U.S. billion since pandemic U.S. Luke’s Health System says it will lay off workers in Idaho.
5 moves to know Most hospital websites routinely transfer patient data via tracking tools Nonprofit hospitals that pay board members linked to less charity care Nurses, federal lawmakers push for staffing ratio legislation Reports of serious adverse events rose in 2022: Joint Commission Doctors are drowning in paperwork.
Million Individuals Affected by MOVEit Hack MARYLAND Adventist HealthCare, Montgomery College form partnership to address need for qualified nursing workforce Harford Memorial Hospital closing set for Feb. million patients stolen during ransomware attack MINNESOTA CFO of the Year 2023: Penny Cermak, HealthPartners Inc.
Francis emergency room KENTUCKY Apollo’s 220-hospital ‘stranglehold’ harms patients and workers, report alleges Humana cuts ‘small’ number of jobs in multiple locations LMU School of Nursing will open Lexington site at CHI Saint Joseph Health Mercy Health announces acquisition of orthopedic center in Paducah, Ky.
Events Raise $1.4M Mississippi awards 3 Medicaid contracts. Hospitals holding up NC Medicaid deal, Gov. Medicaid patients and county workers brace for the end of the COVID public health emergency. Medicaid gap population growing in South Dakota. 3 best, worst states for long-term care. CALIFORNIA. NORTH CAROLINA.
million deal to sell skilled nursing facilities California health system pays $5 million for alleged Medicaid false claims California’s ASC activity heats up California hospital issues layoffs CommuniCare Health Centers gets $1.5 for Chemotherapy Study US Awards $1.3M Here’s how it could come to a doctor or hospital near you.
Kennedy Jr. to be his Department of Health and Human Services secretary ALABAMA 5 former Ascension hospitals rebrand Andrews Sports Medicine recommended for approval of Alabama ASC Medical Properties Trust cuts Steward from portfolio, hits $801M net loss in Q3 Texas medical office building sells for $7.1M So it cut the gas.
’s ‘Scorched-Earth’ Sanctions Bid YNHH hands out 150 pink slips at Northeast Medical Group s DC Ascension’s Providence Hospital shut down its urgent care center.
Medicaid fraud scheme New York hospital exec chosen to lead Greenwich Hospital Why 5 ASCs are facing opposition 120 doctors in CT are at risk for losing their jobs. Medicaid fraud scheme New York hospital exec chosen to lead Greenwich Hospital Why 5 ASCs are facing opposition 120 doctors in CT are at risk for losing their jobs.
We organize all of the trending information in your field so you don't have to. Join 26,000+ users and stay up to date on the latest articles your peers are reading.
You know about us, now we want to get to know you!
Let's personalize your content
Let's get even more personalized
We recognize your account from another site in our network, please click 'Send Email' below to continue with verifying your account and setting a password.
Let's personalize your content