Provider Trust

JULY 8, 2022

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. The National Practitioner Data Bank (NPDB) is a confidential information clearinghouse operated by the U.S.

Licensing 52

Licensing Malpractice Fraud Medicaid 52

MedTrainer

SEPTEMBER 5, 2024

This confidential clearinghouse primarily aims to safeguard public interest and healthcare quality while reducing fraud and abuse. A CVO gathers information and verifies providers’ credentials through multiple sources on behalf of their own or other organizations, ultimately granting privileges to the specific health system.

Malpractice 52

Malpractice Fraud Licensing Compliance 52

Verisys

AUGUST 31, 2023

Here are seven red flags to look out for and the reasons why: Incomplete or inconsistent application: Missing or conflicting data regarding education, training, work history, licensure, or malpractice history might indicate false information or attempts to conceal relevant details.

Malpractice 52

Malpractice Fraud Medicaid Medicaid 52

Verisys

JULY 20, 2023

2: Having incomplete enrollment applications The average provider enrollment application requires an overwhelming amount of information and data. Unfortunately, the surgeon provided false information on the application, and the hospital’s failure to detect it led to patient harm when hip surgery went awry. Mistake No.

Due Diligence 52

Due Diligence Malpractice Licensing Hospitals 52

Physician Credentialing Company

JULY 15, 2024

By validating staff competence, it reduces the likelihood of malpractice claims and legal issues. This process reduces the risk of fraud and ensures accuracy. It also involves checking for any disciplinary actions or malpractice history. Healthcare facilities benefit financially from credentialing as well.

Malpractice 52

Malpractice Compliance Licensing Medical Billing 52

Total Medical ComplianceHIPAA

JANUARY 11, 2024

These screenings search through various databases containing records of individuals or organizations barred from participating in Medicaid, Medicare, or other federal/state healthcare programs due to fraud, abuse, or other offenses. Why is Sanction Screening Vital Under HIPAA?

HIPAA 52

HIPAA Malpractice Regulatory Compliance Compliance 52

MedTrainer

FEBRUARY 5, 2024

This process typically involves submitting an application with detailed information regarding the provider’s qualifications and licenses. Information about the employer’s Taxpayer Identification Number (TIN) , practice location, and protocol agreements are also needed.

Licensing 52

Licensing Governance Compliance Fraud 52

AIHC

SEPTEMBER 5, 2023

Telehealth is a subset of e-health and is the use of telecommunications technology in health care delivery, information, and education according to the Health Resources and Services Administration (HRSA). However, they would share information and processes essential to these providers’ licensure and regulations.

COVID-19 59

COVID-19 Telemedicine Informed Consent Compliance 59

Verisys

FEBRUARY 6, 2025

Provider data management in healthcare is the systematic process of collecting, organizing, and maintaining accurate information about healthcare providers. It’s all about keeping provider information current and accessible, helping healthcare systems run more efficiently and deliver better care. The key components include.

Regulatory Compliance 52

Regulatory Compliance Compliance Licensing Malpractice 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.

Malpractice 52

Malpractice Due Diligence Compliance Licensing 52

MedTrainer

MARCH 14, 2024

The specialist authenticates the provider’s education, work history, licenses, and other information during provider credentialing. The specialist contacts other parties and primary sources to verify the provider’s information – prior employers, references, and educational institutions.

Malpractice 52

Malpractice Licensing Hospitals Compliance 52

Verisys

DECEMBER 5, 2023

Because they have first-hand knowledge, these primary sources can confirm if the information claimed is accurate. The policy issuer for malpractice insurance verifies insurance coverage. The American Medical Association (AMA) Physician Masterfile contains information about 1.4

Governance 52

Governance Licensing Malpractice Medicaid 52

Verisys

MARCH 1, 2022

Because they have first-hand knowledge, these primary sources can confirm if the information claimed is accurate. The policy issuer for malpractice insurance verifies insurance coverage. The American Medical Association (AMA) Physician Masterfile contains information about 1.4 Government and Non-Government Sources.

Governance 52

Governance Licensing Malpractice Medicaid 52

Verisys

FEBRUARY 6, 2025

Verification of Education and Licenses The process typically begins with the nurse applying, including their educational background, work history, and current licensure information. Let’s not forget the constant back-and-forth with applicants to get that one missing piece of information.

Nurses 52

Nurses US Department of Health and Human Services Licensing Regulatory Compliance 52

Verisys

APRIL 27, 2023

Verisys’ proprietary dataset, Fraud Abuse Control Information System (FACIS) , is the largest and most comprehensive dataset for screening allied health and medical providers. Our solutions are fully accredited by NCQA and URAC, allowing us to maintain the industry’s highest data and compliance standards. With over 5.5

Malpractice 52

Malpractice Licensing Fraud Medicaid 52

Compliancy Group

JANUARY 18, 2022

These audits and their analysis are designed to identify any vulnerabilities in how your practice uses, stores, accesses, and secures protected health information (PHI) of patients. HIPAA compliance begins with a HIPAA security risk assessment and the five audits that are associated with it.

HIPAA 52

HIPAA Compliance Ransomware Malpractice 52

AIHC

AUGUST 30, 2023

Written by: Nancie Lee Cummins, CFE, CHA, CIFHA, OHCC, CHCM, CHCO, CORCM Due to the high volume of fraud schemes involving telemarketing revealed by the Department of Justice (DOJ) over recent years, it is important that providers heed “buyer beware” when engaging with a telemarketing firm. “If If it is too good to be true it probably isn't.”

Compliance 52

Compliance Fraud Medicare Medicare 52

Verisys

FEBRUARY 10, 2022

To stay in compliance with federal and state regulations and to keep patients safe, it’s vital for hospitals and health systems to monitor the licenses of their practitioners for new information that may prevent a physician from practicing. Malpractice Certification of Insurance. Licenses, Certifications, and Registrations to Verify.

Licensing 52

Licensing US Department of Health and Human Services Malpractice Compliance 52

Healthcare IT Today

NOVEMBER 13, 2024

The goal of this requirement is to eliminate fraud and abuse. Providers are often required to submit extensive personal information, including Social Security numbers, home addresses, and even fingerprints in some cases. Adding to the complexity, some states require detailed historical information.

Medicaid 70

Medicaid Medicaid Hospitals Malpractice 70

Hall Render

OCTOBER 25, 2024

Million in Tucson Steward Arizona behavioral hospital gets interim manager Former AZ Department of Health employee charged in Medicaid fraud indictment Arizona hospital performs kidney transplant using robotic technology ARKANSAS NIH Director “blown away” by health care efforts in Arkansas Arkansas Gov.

Nursing Homes 40

Nursing Homes Nurses Hospitals Doctors 40

Hall Render

MARCH 14, 2025

Regional Health named one of the best places to work in Kentucky UK HealthCare taps chief revenue officer LOUISIANA Louisiana opens $33M mental health hospital Louisiana physician, wife to pay $450K for neurostimulator fraud scheme Louisiana physician charged for $6.6M Vincent hospital names chief medical officer UAMS Awarded $1.9M

Nurses 40

Nurses Nursing Homes Medicaid Medicaid 40

Hall Render

JUNE 7, 2024

for patient experience Emory Hospital Midtown will ‘move to normal operations’ after water pressure returned overnight Marietta’s Wellstar medical center now one of three Level I trauma centers in metro Atlanta Northside Hospital programs prioritize mental health in the workplace Rural U.S. health care is in a crisis. million bird flu shots to U.S.

US Department of Health and Human Services 40

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

Hall Render

MAY 26, 2023

Anthony’s Hospital celebrates expansion, renovation project milestone ‘Our voices weren’t being heard’: COVID-19 restrictions rolled back in Metro nursing home Nebraska lawmakers send $10.7 Fallout from settlement in Barrington COVID-19 vaccine lawsuit?

Nursing Homes 40

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

Hall Render

AUGUST 11, 2023

to advance nursing education OREGON Bomb threat shuts down OHSU clinic after anti-trans information posted online CEO of CareOregon on maximizing state health care spending Portland-area medical clinic expands in Northeast and Clackmas County Providence St. million grant on hold Data breach exposes information on 1.7M

US Department of Health and Human Services 40

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

Hall Render

AUGUST 16, 2024

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

US Department of Health and Human Services 40

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

Hall Render

AUGUST 16, 2024

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

US Department of Health and Human Services 40

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

Hall Render

JULY 21, 2023

Luke’s named to Becker’s Great Heart Programs list Univ. 11th in mental health, No. 1 for adults and No. Luke’s named to Becker’s Great Heart Programs list Univ. 11th in mental health, No. 1 for adults and No. Luke’s named to Becker’s Great Heart Programs list Univ. 11th in mental health, No. 1 for adults and No.

US Department of Health and Human Services 40

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

Hall Render

NOVEMBER 1, 2024

fraud scheme Blue Cross Blue Shield, Phoenix Children’s at odds over contract renewal Former Tucson Heart Hospital to become El Rio Health clinic California company will manage troubled St. Vincent’s acquisition on Nov. Peter’s Health Reaches $10.8

Nursing Homes 40

Nursing Homes Nurses Hospitals Doctors 40

Hall Render

FEBRUARY 10, 2023

over Claims Practices Where things stand in Central California 1 month after a community hospital’s closure California hospital names Kelly Linden CEO Upcoming California health bills to watch, including a conversation with Rep. million to UMass Memorial Health Care for COVID-19 costs Four Mass.

US Department of Health and Human Services 40

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

Hall Render

MARCH 1, 2024

KXAN investigates Does UT Tyler Health Science Center’s deal with private equity shield doctors from malpractice suits? R1 RCM posts $3.3M in 2023 income Ransomware group leader told hackers to attack hospitals, FBI, HHS say The 23 health systems pushing Congress to act on virtual care Three examples of how AI is going to change medicine U.S.

Nursing Homes 40

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

Hall Render

DECEMBER 22, 2023

fraud scheme UConn Health is in financial trouble. Alexius Devils Lake Hospital renovations Closing the Medicaid Gap Is Just the First Step, as Nursing Homes Fight for Predictable Reimbursement Sanford nursing director back home after an opportunity to help a hospital in Costa Rica What do malpractice payments look like in North Dakota?

Nursing Homes 40

Nursing Homes Nurses COVID-19 Hospitals 40

Hall Render

APRIL 14, 2023

But hospitals say they can’t afford to pay California hospital nurses to receive raises of up to 30% California pharmacist pleads guilty to multi-year Medicare fraud scheme Carmichael-based Eskaton pays $5.5

Nursing Homes 40

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

Hall Render

NOVEMBER 17, 2023

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. Many more are waiting.

Nursing Homes 40

Nursing Homes Nurses Hospitals Doctors 40

Hall Render

APRIL 7, 2023

Judge denies challenge to measure that would cap LA hospital exec pay COLORADO Builders show little interest in city, hospital employee housing project Capitol Pain Institute acquires 3 Colorado practices, ASC Colorado lawmakers seek financial information from hospitals in larger debate over health care costs Colorado to advance $1.4

US Department of Health and Human Services 40

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

Hall Render

DECEMBER 15, 2023

Fitch Revises Outlook on Dartmouth-Hitchcock Health (NH) to Negative; Affirms IDR and Revs at ‘A’ NEW JERSEY 2 nurses, medical resident injured in attack at New Jersey hospital, authorities say New Jersey man convicted in $4M fraud scheme NJ hospitals make progress after crippling cyberattacks According to U.S.

Nursing Homes 40

Nursing Homes Nurses Hospitals COVID-19 40

Hall Render

SEPTEMBER 27, 2024

Jaya Raj fosters relatable health care ARKANSAS 5 ASC legal cases, controversies in 1 month UAMS Report Shows Financials Improved in Fiscal Year 2023 Clinical Transaction Checks In at $1.5M Million Settlement with L.A. Million Settlement with L.A. headcount among top 10 biopharma employers shrinks New Mass.

Nurses 40

Nurses Hospitals Nursing Homes Medicare 40

Hall Render

JUNE 30, 2023

NATIONAL 3 big noncompete ban wins for physicians 5 systems join $50M poverty and cancer program AHA advises Congress how to advance MACRA payment models Amazon delays virtual care service’s unveiling after senators raised privacy concerns At AHA Hill briefing, hospital leaders say site-neutral payment cuts jeopardize access to care for patients and (..)

US Department of Health and Human Services 40

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