Fraud Governance Licensing Malpractice 
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. Provider credentialing confirms a provider’s qualifications.
MedTrainer
JULY 28, 2023
Earlier this year, an in-depth OIG investigation resulted in a six-day trial of a former Louisiana health clinic CEO , who was ultimately convicted of Medicaid fraud and sentenced to 82 months in federal prison. This ensures that medical facilities are not engaging in malpractice and following program rules and regulations.
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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.
Verisys
DECEMBER 5, 2023
State licensing boards verify practitioner license type and status. An Office of Inspector General (OIG) search of the List of Excluded Individuals/Entities (LEIE) indicates if the licensee is excluded from participating in government-funded programs. The policy issuer for malpractice insurance verifies insurance coverage.
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.
Verisys
MARCH 1, 2022
State licensing boards verify practitioner license type and status. An Office of Inspector General (OIG) search of the List of Excluded Individuals/Entities (LEIE) indicates if the licensee is excluded from participating in government-funded programs. The policy issuer for malpractice insurance verifies insurance coverage.
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.
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