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7 Examples of What Could Happen Without Medical Credentialing

MedTrainer

Let’s review some key information that’s verified during credentialing and discuss examples of what could happen without medical credentialing. Key Information Medical Credentialing Verifies Most people think of healthcare providers as physicians, physician assistants, and other advanced practice professionals.

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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. This process typically involves submitting an application with detailed information regarding the provider’s qualifications and licenses. Several weeks.

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Aetna Provider Enrollment: What To Expect

MedTrainer

We’ll walk you through the steps to enroll providers with Aetna (a CVS Health company), the information and documents you’ll need, and best practices to follow. Aetna systems will reflect your provider’s participation effective date, and Aetna members can see the provider’s information in the directory.

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HRSA Credentialing: Master the Operational Site Visit

MedTrainer

The visit usually lasts three days, during which the surveyor will meet with center leaders and board members to gather information and assess compliance. Credentialing Activity LIP OLCP; Other Clinical Staff Verification of identity (for initial credentialing) Government-issued picture identification.

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Quick Guide to the National Practitioner Data Bank (NPDB)

Provider Trust

A holistic approach to exclusion monitoring and license verifications must include monitoring of disciplinary databases such as the National Practitioner Data Bank (NPDB). The National Practitioner Data Bank (NPDB) is a confidential information clearinghouse operated by the U.S. For more information, view the webinar on demand.

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Primary Source Verification: One of the Hidden Secrets to Ensuring Excellence in Any Healthcare Organization

Verisys

Missing critical information in the credentialing process can significantly affect your organization. This helps guarantee that all practitioners in your organization meet the requisite licensing and certification requirements. Bottlenecks can pop up every step along the way, prolonging the process.

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The Importance of Primary Source Verification for Practitioner Credentials

Verisys

Because they have first-hand knowledge, these primary sources can confirm if the information claimed is accurate. State licensing boards verify practitioner license type and status. The policy issuer for malpractice insurance verifies insurance coverage. And the list goes on.…