Credsy blog

VBC is a novel reimbursement methodology linking payment directly to the quality of care provided. It functions as a promising alternative to conventional fee-for-service reimbursement, rewarding healthcare providers for efficiency and effectiveness, as opposed to the sheer volume of services.

The Centers for Medicare & Medicaid Services (CMS) recently issued a proposed rule that would update the Medicare inpatient prospective payment system (IPPS) and long-term care hospital prospective payment system (LTCH PPS) for fiscal year (FY) 2024. The proposed rule affects the payment rates and policies for acute care hospitals and LTCHs that provide services to Medicare beneficiaries.

As a healthcare professional, it's vital to keep your licenses and credentials up-to-date. Any delays or problems in the licensing and credentialing process can jeopardize the continuity of your practice. In this article, we'll share ten invaluable tips to help you streamline these processes, ensuring you avoid any obstacles that may arise.

Uniform application is a web-based application that simplifies the licensure process for physicians, physician assistants (PAs), and residents by allowing them to apply to multiple state boards with one application. Boards are state medical and osteopathic boards that regulate the practice of medicine and grant licenses to qualified applicants.

The COVID-19 pandemic has significantly disrupted the healthcare system, yet it has also provided telehealth with an opportunity to demonstrate its worth and potential in delivering care and safeguarding public health.

As the healthcare industry becomes increasingly specialized and standards evolve, ensuring providers are adequately qualified is paramount. Credential Verification Organizations (CVOs) play a crucial role in this regard. In this article, we discuss the role of CVOs and how they can increase healthcare efficiency and lower operating costs.

In this article, we delve into the complexities of provider network management, exploring the challenges and proposing solutions to streamline these critical processes and provide healthcare organizations with actionable strategies to optimize their provider networks.

The quality and safety of patient care are significantly impacted by the accurate credentialing of healthcare professionals. Unfortunately, this process can be both daunting and time-consuming for professionals and organizations alike. However, the Federation of State Medical Boards (FSMB) offers a solution to this problem: FCVS.

Telehealth services have already shown and proved the potential they possess to make a positive impact on people’s lives. It is delivering care to patients who may not have access to nearby or affordable health facilities. This can help improve health outcomes, lower costs, and enhance the quality of life.

As the healthcare industry continues to evolve, it’s more important than ever to ensure that your revenue cycle management processes are efficient and effective. One way to achieve this is through the practice of credentialing, which is the process of verifying the qualifications and experience of healthcare professionals.

Discover the components and features of credentialing software to make an informed decision and elevate your organization’s credentialing process.

In healthcare where accuracy and communication are paramount, PECOS (Provider Enrollment, Chain, and Ownership System) emerges as a crucial bridge between providers and the Centers for Medicare & Medicaid Services (CMS).

The healthcare industry operates within a complex web of regulations, which we refer to as regulatory compliance. These regulations, established by entities called medical regulatory bodies, dictate standards that ensure the quality, safety, and efficiency of health services and products.

This article serves as a deep dive into the world of cloud-based medical credentialing software. We explore how this transformative technology can help tackle these challenges and offer substantial benefits to healthcare organizations. Furthermore, we will provide insights on how to select the most suitable cloud-based medical credentialing software tailored to your unique needs and objectives.

For those in the healthcare sector, credentialing has always been a pivotal process, ensuring that healthcare services maintain their high standards of quality and safety. But as we move through 2023, the landscape of healthcare credentialing is undergoing significant transformations.

Credentialing software isn't merely a tool—it's a strategic asset. Discover the features crafted to streamline the credentialing process.

The transition to digital healthcare presents both opportunities and challenges, particularly in integrating providers into new telehealth platforms. Understanding the nuances of credentialing versus payer enrollment, including delegated and direct credentialing, is crucial for maintaining a healthcare practice's reputation and managing its revenue cycle effectively.

Staying current with the newest medical developments and skills is critical for healthcare professionals, striving to give excellent care to their patients. This is where continuing medical education (CME) comes in. Failing to meet renewal and continuing medical education requirements can have severe consequences, such as losing your medical license or facing disciplinary action from the state medical board. It's essential to navigate these requirements successfully to ensure the continuity of your practice and the well-being of your patients. In this guide, we'll provide you with the information and knowledge you need to confidently navigate medical license renewal and CME requirements. We'll cover everything from the basics of CME education for physicians and assistants to state-specific requirements, different types of continuing medical education events, and how to meet accreditation standards.

Finding proficient physicians to meet your staffing demands may be a daunting task. Whether you are confronting a short-term vacancy, a peak season rush, or a persistent shortage, the appointment of locum tenens physicians can serve as a practical and advantageous option.

Credentialing is a necessary and critical process in the healthcare industry, ensuring that healthcare providers are qualified to treat patients. However, the process can be time-consuming and prone to errors due to its complexity. These mistakes can cause significant problems for both the healthcare facility and the provider, with consequences ranging from delayed payments to fines and legal action. It's essential to identify and avoid these mistakes to streamline the credentialing process and ensure patients receive quality care. In this article, we'll discuss the most common credentialing mistakes and ways to troubleshoot and avoid them. So that you could successfully navigate the medical credentialing process and ensure compliance with regulatory standards.

Healthcare provider credentialing is a process that goes beyond a simple procedure; it's a vital aspect of maintaining top-notch patient care. In this article, we will dive deep into the world of credentialing and privileging, emphasizing its significance in reducing medical errors, fostering professionalism, and improving overall healthcare outcomes.

The compact nursing licenses are revolutionizing the way nurses practice and healthcare employers recruit across the United States. The compact license enables nurses to work in different states without the hassle and cost of obtaining additional licenses. This, in turn, provides healthcare employers with a larger pool of qualified nursing candidates. Navigating the NLC's intricacies can be daunting, which is why we've put together this comprehensive guide that covers everything you need to know. We discuss the basics of the multi state license, the benefits it provides, and how to obtain a new license both under the compact and by endorsement. This guide will help you make the most of the compact license. So let's dive in and make the most of this game-changing agreement!

Traditionally, credentialing has been a time-consuming, manual, and error-prone endeavor, often causing delays in provider onboarding and scheduling, along with the revenue that comes from patient care. However, automation is stepping in, swiftly changing the medical credentialing arena for the better. In this article, we delve into what provider credentialing entails and how automation is streamlining the process. This shift is not only enhancing efficiency and provider satisfaction but also speeding up the time to revenue for healthcare organizations.

Picture this: You're running a thriving healthcare practice, focused on providing top-notch patient care. One day, you notice that reimbursements are taking longer than usual, and some claims are even denied. You wonder what went wrong. Could it be that you've neglected the importance of provider data maintenance in your credentialing and enrollment processes?

In the swiftly changing healthcare environment, payor enrollment emerges as a critical process, pivotal for smooth medical billing and cultivating patient trust. However, its complexities often baffle many healthcare providers and organizations. This guide endeavors to clarify payor enrollment, emphasizing its importance and presenting best practices for effective navigation.

In the vast realm of healthcare, credentialing stands out as a cornerstone, validating the expertise, qualifications, and trustworthiness of professionals and institutions we rely on for our health. Far from being a mere administrative step, credentialing acts as a protective shield, a mechanism ensuring the highest standards of care that every patient rightfully anticipates.

The COVID-19 pandemic has caused a seismic shift in the way healthcare is delivered. Telemedicine has been critical in ensuring that patients receive the treatment they require, even when face-to-face appointments are not feasible. However, telehealth licensing requirements pose significant challenges for providers. Meeting them involves navigating a complex maze of regulations and guidelines, which can be both time-consuming and costly. Fortunately, technology is streamlining the process, making it easier than ever before to overcome any barrier.

Telehealth is revolutionizing the healthcare industry, offering benefits like video consultations, remote patient monitoring, and mobile health apps. It has already enhanced care accessibility, quality, and efficiency for patients, particularly those in rural or underserved areas, and continues to expand.

As a healthcare provider, you're undoubtedly aware of the importance of maintaining your credentials and adhering to professional standards and regulations. Credentialing is the method of confirming and validating your qualifications, education, training, experience, and licenses required for your field of practice. This process is critical to ensuring the quality and safety of your services, as well as securing contracts and reimbursements from health insurance companies and other payers.

Payor enrollment and credentialing are two crucial steps healthcare providers must complete to join health insurance networks and receive payment. These procedures make sure that providers follow quality standards and eligibility requirements set by health plans, as well as adhere to government program rules and policies.

How crucial do you reckon compliance is in the realm of healthcare? Compliance isn't merely a legal mandate, it's also a linchpin for trust and reputation. So if you're operating as a healthcare provider or institution, it's essential for you to understand the risks and potential fallout of breaching industry rules and regulations. Indeed, one of the most severe repercussions is facing exclusion or sanctions from federal or state agencies.

Every healthcare provider knows how time-consuming and tedious it can be to fill out credentialing applications for different health plans and organizations. You must repeatedly submit the same information, frequently on paper forms that are prone to mistakes and delays. Wouldn't it be good to streamline this procedure and spare you the time and hassle?

Locum tenens can offer many benefits to both healthcare organizations and providers, such as addressing staffing shortages, covering for leaves of absence, meeting seasonal demands, and exploring new opportunities.

In today's fast-paced healthcare industry, staying competitive is crucial to your career success. Holding multiple medical licenses is a proven strategy to gain an edge over your peers, yet it's often overlooked.

Payer contracting is the bedrock of negotiations between healthcare providers and insurance companies, outlining the terms of service provision and payment. The influence of payer contracting permeates every facet of healthcare, from the financial stability of healthcare institutions, and the quality of patient care, to patient satisfaction levels.