MedTrainer

MARCH 23, 2024

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.

Licensing 52

Licensing Malpractice Governance Nurses 52

MedTrainer

MARCH 22, 2024

We’ll walk you through the steps in enrolling with Cigna, the information and documents you’ll need, common challenges you may encounter, and best practices to follow. Once Cigna verifies the information on the credentials, the health plan credentialing committee will receive the application.

Malpractice 52

Malpractice Licensing Hospitals 52

The Health Law Firm Blog

MARCH 11, 2024

By: George F. Indest III, J.D., Board Certified by The Florida Bar in Health Law and Hartley Brooks, Law Clerk, The Health Law Firm On November 22, 2023, the Supreme Court of Pennsylvania unanimously decided that a serial killer cannot sue his psychiatrist for gross negligence because the action is barred by the [.]

Malpractice 52

Malpractice Licensing Nurses 52

Verisys

JULY 20, 2023

An organization must verify all certifications and licenses for every provider who administers patient services. 2: Having incomplete enrollment applications The average provider enrollment application requires an overwhelming amount of information and data. Mistake No. Mistake No. Mistake No. Mistake No. Mistake No. Mistake No.

Due Diligence 52

Due Diligence Malpractice Licensing Hospitals 52

The Health Law Firm Blog

FEBRUARY 6, 2024

By: George F. Indest III, J.D., Board Certified by The Florida Bar in Health Law and Hartley Brooks, Law Clerk, The Health Law Firm On November 22, 2023, the Supreme Court of Pennsylvania unanimously decided that a serial killer cannot sue his psychiatrist for gross negligence because the action is barred by the [.]

Malpractice 52

Malpractice Licensing Nurses 52

Medisys Compliance

MARCH 21, 2023

By credentialing doctors, insurance companies can ensure that their customers receive high-quality care and that the doctors they work with are qualified and licensed to provide the care they need. By verifying a doctor’s credentials, insurance companies can mitigate the risk of malpractice claims and ensure patient safety.

Doctors 52

Doctors Malpractice Licensing Medical Billing Outsourcing 52

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). The National Practitioner Data Bank (NPDB) is a confidential information clearinghouse operated by the U.S. For more information, view the webinar on demand.

Licensing 52

Licensing Malpractice Fraud Compliance 52

MedTrainer

APRIL 27, 2024

The visit usually lasts three days, during which the surveyor will meet with center leaders and board members to gather information and assess compliance. Verification of current licensure, registration, or certification Primary source verification (PSV) directly from the state licensing agency/body.

Licensing 52

Licensing Compliance Malpractice Governance 52

Verisys

AUGUST 17, 2023

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.

Malpractice 52

Malpractice Licensing Compliance Medicaid 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

MedTrainer

JULY 10, 2023

Credentialing organizations verify that healthcare providers hold valid and unrestricted licenses to practice medicine and any additional certifications relevant to their specialties. This involves checking for any disciplinary actions, malpractice claims, or adverse events related to the provider’s practice. Review and evaluation.

Malpractice 52

Malpractice Compliance Licensing Hospitals 52

MedTrainer

FEBRUARY 29, 2024

Here are the main insurance credentialing steps: Gather and Verify Provider Information: Before initiating the insurance credentialing process, healthcare organizations must first complete the provider credentialing process. This typically involves gathering and verifying the provider’s information and credentials.

Malpractice 52

Malpractice Licensing Nurses Governance 52

MedTrainer

APRIL 18, 2024

CAQH credentialing is designed to alleviate the work for providers because many major payers can access that information without the provider completing a separate application. Many payers require providers to maintain a CAQH ProView profile. Get the tools you need to eliminate delays in your provider enrollment process.

Licensing 52

Licensing Malpractice Compliance 52

MedTrainer

AUGUST 9, 2023

What Documents and Information Are Required? This form collects general information such as personal details, contact information, and professional background. Licenses and Certifications. Copies of all current and valid medical licenses, board certifications, and registrations must be submitted. Work History.

Malpractice 52

Malpractice Licensing Compliance 52

MedTrainer

APRIL 18, 2024

CAQH credentialing is designed to alleviate the work for providers because many major payers can access that information without the provider completing a separate application. This may include proof of licensure, certification, accreditation, malpractice insurance, DEA registration (if applicable), and other supporting documentation.

Medicare 52

Medicare Medicare Licensing Compliance 52

MedTrainer

JULY 10, 2023

Credentialing organizations verify that healthcare providers hold valid and unrestricted licenses to practice medicine and any additional certifications relevant to their specialties. This involves checking for any disciplinary actions, malpractice claims, or adverse events related to the provider’s practice. Review and evaluation.

Malpractice 40

Malpractice Compliance Licensing Hospitals 40

MedTrainer

APRIL 26, 2024

Primary source verification involves contacting original sources — such as educational institutions, licensing boards, and certification bodies — to confirm the authenticity and accuracy of the documents and qualifications provided by the provider. If the dentist is being credentialed in a state with its own portal, set that up as well.

Medicare 52

Medicare Medicare Malpractice Licensing 52

MedTrainer

JULY 10, 2023

Even after someone goes through all the schooling, passes their medical boards and obtains a license to practice, physician credentialing still stands between a provider and patients — no matter where they are in their career. Malpractice history. It takes more than a medical degree to practice medicine. Work history. References.

Malpractice 40

Malpractice Licensing Compliance Regulatory Compliance 40

MedTrainer

NOVEMBER 27, 2023

The State Medical Board of Ohio provides licensing and regulatory guidelines for medical providers in Ohio State. The Counselor, Social Worker, and Marriage and Family Therapist Board oversees regulatory adherence and licensing for mental/behavioral health providers and social workers. Learn more about MedTrainer today!

Compliance 52

Compliance Licensing Medicaid Medicaid 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

MedTrainer

SEPTEMBER 20, 2023

Legal costs, settlements, and increased malpractice insurance premiums can put financial burdens on ASCs found guilty of negligent credentialing. This process should include comprehensive checks of education, training, licensure, malpractice history, and any disciplinary actions. Financial Consequences. Long-Term Consequences.

Malpractice 52

Malpractice Licensing Due Diligence Compliance 52

Verisys

JANUARY 11, 2022

These must include issuing state, license type, license number, status, and issue and expiration dates. Healthcare-specific information on state/federal criminal convictions or civil judgments. Malpractice history and hospital sanctions. Malpractice Insurance. Accurate, compliant, and complete information.

Malpractice 52

Malpractice Licensing Health Insurance Hospitals 52

MedTrainer

DECEMBER 20, 2023

Both licensing and credentialing processes are pivotal in upholding the integrity and safety of healthcare delivery in the state of New Jersey. The New Jersey State Board of Medical Examiners oversees medical credentialing and licensing within the state. Primary Source Verification. Payers in New Jersey have specific requirements.

Licensing 52

Licensing Medicaid Medicaid Malpractice 52

MedTrainer

OCTOBER 29, 2023

Physical License Only California currently provides physical licenses for practitioners. This wallet-size license requires holders to scan, photocopy, or take a picture for recredenialing or verification. It can take as long as four to five months to credential a new provider simply because of this backlog. Background Checks.

Licensing 52

Licensing Malpractice Medicaid Medicaid 52

Medisys Compliance

MARCH 27, 2023

This process typically involves a thorough review of the provider’s education, training, licensure, certification, work history, and other relevant information to ensure they meet the standards and requirements set forth by regulatory bodies, healthcare organizations, and insurance companies.

Malpractice 52

Malpractice Medical Billing Outsourcing Governance Patient Satisfaction 52

Verisys

DECEMBER 5, 2023

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. The Masterfile obtains records directly from medical schools.

Governance 52

Governance Licensing Malpractice Medicaid 52

Verisys

JANUARY 19, 2022

Ensures proper credentialing and privileging of the licensed medical staff. These costs can accrue directly from credentialing neglect, such as incurring civil monetary penalties, lawsuits, and loss of federal funding, or indirectly, when theft, adverse events, malpractice litigation, and hospital-acquired infections occur.

US Department of Health and Human Services 52

US Department of Health and Human Services Hospitals Malpractice Compliance Officers 52

MedTrainer

OCTOBER 29, 2023

The Colorado Medical Board oversees medical credentialing and licensing within the state. Controlled Substance Licensure Colorado has a one license requirement for controlled substance licensure. Revalidation every five years is required for providers to remain enrolled. Primary Source Verification. Background Checks. Payer Enrollment.

Licensing 52

Licensing Malpractice Medicaid Medicaid 52

Provider Trust

APRIL 14, 2023

When a healthcare provider or organization bills a payer for services rendered, payers need up-to-date credentialing data to ensure these providers are properly licensed to give expert clinical services. Providers should be informed about the steps that need to be taken and the time frame for completion.

Licensing 52

Licensing Compliance Malpractice Medicaid 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 Compliance Informed Consent 59

Medisys Compliance

OCTOBER 30, 2023

It involves submitting an application that includes your qualifications, licensure, and other essential information to demonstrate your competence and eligibility to provide mental health services. Mental health credentialing is the process of becoming an approved provider with insurance companies or government health programs.

Medical Billing Outsourcing 59

Medical Billing Outsourcing Medical Billing Malpractice Licensing 59

Hall Render

DECEMBER 12, 2023

CMS stated that this could include any misdemeanor that places the Medicare program or its beneficiaries at immediate risk, such as a malpractice suit that results in a conviction of criminal neglect or misconduct. Hall Render blog posts and articles are intended for informational purposes only.

Medicare 40

Medicare Medicare Licensing Malpractice 40

Verisys

MARCH 1, 2022

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. Government and Non-Government Sources.

Governance 52

Governance Licensing Malpractice Medicaid 52

MedTrainer

FEBRUARY 13, 2022

By ensuring that healthcare providers have the proper license and documentation to provide treatment, they are safeguarding the health and wellbeing of their patients as well as protecting the facility from potential liabilities. Licensing Requirements: Ensuring that the healthcare professional has the proper licensing to practice medicine.

Licensing 40

Licensing Malpractice Governance Compliance 40

Verisys

DECEMBER 1, 2023

It is understood throughout the industry that NCQA CVO Certification means an organization demonstrates high performance in internal quality improvement processes, security of credentialing information, and the efficient and accurate verification of credentials. Visit verisys.com to learn how we turn problems into power.

Medicaid 52

Medicaid Medicaid Medicare Medicare 52

Healthcare IT News - Telehealth

JUNE 13, 2023

There has been a lot of discussion about state licensure and the fact that our system of healthcare is divided up on a state-by-state basis where local medical boards hold the authority to grant licensure, when our nation would obviously benefit from a single universal license or a system of reciprocity.

Licensing 135

Licensing Telemedicine Hospitals Nurses 135

HIT Consultant

FEBRUARY 5, 2024

Credentialing lapses can expose a healthcare organization to malpractice suits and accreditation problems. All certifications and licenses must be verified for every provider who administers services to patients. The average physician enrollment application requires an overwhelming amount of information and data. Mistake No.

Malpractice 96

Malpractice Licensing Due Diligence Hospitals 96