Feb 11, 2020 | Medical Credentialing, Revenue Cycle Management Solutions
Hospitals strive to place two goals at the forefront of their day-to-day operations: patient safety and continual improvement of the quality of care that the facility provides for its patients. These goals are often diametrically opposed to another key item on the...
Feb 11, 2020 | Medical Credentialing, Revenue Cycle Management Solutions
Among healthcare practitioners, there is sometimes confusion between “payer enrollment” and “medical credentialing”. The process of payer enrollment and credentials verification is intricate and it becomes more so with each passing year. Contract with a CVO Without...
Feb 11, 2020 | Medical Credentialing, Revenue Cycle Management Solutions
CVO credentialing refers to the use of a Credentials Verification Organization to perform medical credentialing on behalf of a healthcare practice or organization. The CVO is tasked with obtaining primary source verification of a provider’s documents on the...
Feb 11, 2020 | Medical Credentialing
Verifying medical credentials is an essential consumer safety component of the health care system. To safely administer health care for their patients, organizations must verify the qualifications of their licensed medical providers by assessing their background and...
Feb 11, 2020 | MACRA Solutions
In April 2015, Congress eliminated the SGR (Sustainable Growth Rate) — the formula used to calculate Medicare payments to healthcare providers. In its vacancy came the newly proposed Quality Payment Program and MACRA (Medicare Access and CHIP Reauthorization Act of...
Feb 11, 2020 | Medical Credentialing, Revenue Cycle Management Solutions
As a physician or other healthcare provider, you must apply for initial medical credentialing and be re-credentialed every 2-3 years, depending on the state in which you live and the policies of your payers. It’s a monumental task, but a necessary one, as...
Feb 11, 2020 | Medical Credentialing, Revenue Cycle Management Solutions
Medical credentialing is an in-depth and meticulous process. The standards set forth by regulatory bodies like the National Committee for Quality Assurance (NCQA) require preliminary and ongoing review of a healthcare provider’s qualifications. These include, but are...
Feb 11, 2020 | Medical Credentialing, Revenue Cycle Management Solutions
If your medical credentialing is still being done with filing cabinets, paper, spreadsheets, email, and fax, upgrading to medical credentialing software or a total outsourcing solution will save time and effort and increase the accuracy of your credentialing. The long...
Feb 11, 2020 | Medical Credentialing, Revenue Cycle Management Solutions
In healthcare, Physician Credentialing is the process of organizing and verifying a doctor’s professional records. This includes their board certifications, hospital admitting privileges, education, insurance, professional references, work history, and more....
Jan 29, 2020 | Revenue Cycle Management Solutions
One of the most common errors in medical billing and denied claims is an incorrect or missing NPI number. Insurance claims submitted to Medicare, Medicaid or any health plan are not paid without an accurate NPI. An NPI number, known as a National Provider Identifier,...
