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Are Provider Enrollment and Credentialing the Same?

MedTrainer

Provider enrollment is when a healthcare provider is registered with insurance networks or government payers , like Medicaid or Medicare. Watch this on-demand webinar to get tips to speed up your enrollment process. The employer may also review any pending and past medical malpractice cases or disciplinary actions.

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Quick Guide to the National Practitioner Data Bank (NPDB)

Provider Trust

In this quick guide, we’ll explore the importance of including NPDB monitoring in your routine license and exclusion monitoring to protect your organization and the patients you serve from fraud, waste, and abuse. Its mission is to enhance healthcare quality, defend the public, and decrease healthcare fraud and misuse in the U.S.

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Privileges and Credentialing Aren’t the Same

MedTrainer

Additionally, the credentialing specialist may request a record of any pending and past medical malpractice cases and disciplinary actions from the appropriate authority. Whether it’s government regulation or healthcare facility requirements is a matter. Maintaining compliance helps protect against fraud, waste, and abuse.

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What Is Provider Credentialing?

MedTrainer

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.