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.

Grappling with the challenge of scattered provider data is like trying to solve a complex puzzle. This data isn't just a bunch of numbers and names; it's the heartbeat of top-tier healthcare delivery. Harnessing the power of technology to bring all this data under one roof can be a game-changer.

The U.S. healthcare sector allocates a staggering $800 billion each year to administrative costs. In this high-stakes environment, enhancing efficiency in enrollment and credentialing is essential for the financial health of the system.

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.

In 2024, hospitals and health systems have witnessed notable improvements in financial metrics, yet they continue to grapple with increasing costs. Uncover five strategic approaches designed to help your healthcare organization reduce costs, enhance efficiency, and boost revenue generation.

There are several key entities crucial for credentialing: federal and state agencies, professional boards, insurers, healthcare organizations, providers, and credentialing services. Each plays a vital role in ensuring the effectiveness of the credentialing process.

In this article we dive into practical, actionable insights to help streamline the credentialing process, reduce administrative overhead, and guarantee ongoing compliance.

The ongoing credentialing process, as it stands, often feels redundant and creates friction that disrupts providers' ability to manage claims, billing, and collections efficiently. It's not just costly and time-consuming; it often fails to maintain a consistent record that could enhance data integrity throughout the system.

In New Jersey, a beacon of healthcare excellence, the network of 113 hospitals, including 71 dedicated acute care facilities, consistently surpasses national quality benchmarks.

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.

In healthcare, the line between compliance and risk is fine, making vigilance and meticulousness not just virtues but necessities.

For the past ten years, the healthcare scene has been gradually but surely embracing value-based care, a testament to the determined effort of countless professionals. This journey towards prioritizing value in healthcare isn't uniform; while some areas, like patient engagement and streamlined care coordination, have made significant strides, others, especially in leveraging data for decision-making and syncing up providers, are still catching up.

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.

Uncover the core elements impacted by sluggish turnaround times and learn why integrated provider network management systems are the secret to simplifying processes such as credentialing, licensing, and enrollment.

The battle against COVID-19 has showcased remarkable progress globally, yet it has also cast a spotlight on the increasing stress, workforce shortages, and the resultant burnout that are pushing many physicians to leave their professions prematurely.

The NAMSS specifies 13 fundamental criteria for initial provider credentialing. Discover the steps healthcare organizations need to take to streamline credentialing procedures.

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.

Healthcare organizations are under financial strain as they face rising costs, labor shortages, and razor-thin margins. That’s why accelerating credentialing and payer enrollment is more important than ever. The faster providers are credentialed, privileged, and enrolled, the sooner they can start delivering patient care, billing for services, and generating revenue.

The current onboarding methods are often clunky, time-consuming, and expensive, leading to frustration among new clinicians and, at times, delaying patient care.

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.

This article will delve into the advantages of PDMs over MDMs and discuss the potential benefits of integrating an existing MDM with a PDM system.

The tradition of one doctor stepping in for another—referred to as locum tenens, Latin for "to take the place of"—has been a respected practice in the medical field for over two centuries. Doctors have historically covered for each other during illness, travel, or other absences as a mark of professional respect. It wasn't until the 1970s, however, that employing locum tenens doctors shifted from being a casual, impromptu arrangement to a more structured and essential aspect of medical staffing

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.

As the United States braces for healthcare expenditures to reach a staggering $6.2 trillion by 2028, healthcare organizations are increasingly focused on optimizing their operations to boost revenue generation.

Your team pours its heart into delivering top-notch medical care, where cutting corners just isn't in the playbook. The rigorous journey of medical credentialing underscores this commitment, guaranteeing patients can trust in the care they receive. Yet, let's face it, the admin load is hefty, swaying your team's focus from patient care to piles of paperwork. Yes, it's a drag and eats up precious time.

The credentialing process isn't quick—it can stretch from 90 to 120 days, demanding both money and manpower. Rural health organizations often struggle with the resources needed for such a detailed task.

As the U.S. grapples with a growing shortage of physicians, healthcare organizations are increasingly turning to nonphysician providers, including advanced practice professionals (APPs), to bridge this gap. APPs enhance efficiency, patient contentment, and revenue by reducing costs and attracting new patients.

The turnover rate for registered nurses, especially those new to the profession, presents a serious challenge for healthcare systems across the globe. Shockingly, up to 83% of hospital turnover involves these newcomers.

This article demystifies these essential processes, elucidating their roles in the broader context of healthcare operations.

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

Small and solo medical practices face unique hurdles when it comes to credentialing, often stemming from limited administrative resources and the overwhelming demands of managing both patient care and paperwork. These constraints can make it difficult for practitioners to dedicate the necessary time and staff to the credentialing process.

In this article we explore key trends that detail this expansion, break down the critical aspects of telehealth reimbursement, and provide insights into how Medicare and Medicaid adjustments are influencing virtual care practice dynamics.

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.

Are you in search of a smarter, more efficient way to tackle the maze of medical credentialing? From initial setup to embracing automation, there’s a streamlined pathway that can make this entire ordeal far less of a headache for your team.

To ensure your organization maximizes the benefits of its telehealth program and stays compliant with evolving regulations, we've outlined essential strategies to help you grow your telehealth services and remain ahead of industry changes.

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!

Hospitals and healthcare centers often rely on contract labor, like traveling nurses, to fill their staffing needs. However, since the pandemic, the costs associated with hiring these contract nurses have risen sharply. In January 2022, contract travel nurses made up 23% of all nurse hours and nearly 40% of nursing labor costs.

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.

We all know that thorough credentialing and privileging are crucial for patient safety. But here's something you might not expect: these processes also play a huge role in your healthcare organization's financial success. In this article, we're diving into how shrinking the time it takes to generate revenue can make a world of difference in healthcare.

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.

Assessing physician compensation is complex. It's not just about what feels right but what is equitable, sustainable, and linked to health outcomes. Today, when attracting skilled physicians is more competitive than ever, making it essential to understand what drives their compensation.

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.

The role of physician associates in the U.S. healthcare system is both pivotal and growing. Since 2018, the number of certified PAs has increased by 28%, with about 12,000 new positions anticipated annually over the next ten years. These professionals have quickly become central to both specialty and primary care, proving themselves as indispensable assets

Maintaining Joint Commission accreditation is considered the gold standard in healthcare, often necessitating efforts that surpass basic regulatory requirements. This includes comprehensive training programs tailored to the specific needs of an organization.

Nurses are in higher demand now than ever before. Every year, the need for these critical healthcare personnel has increased, a trend that is expected to continue long into the future.

Autonomy is top of mind for many doctors as healthcare becomes more centralized and the trend of doctors becoming employees continues to rise.

Patients entrust their well-being to healthcare providers, often at their most vulnerable times. Delivering anything less than high-quality care can lead to significant repercussions. It is for this reason that primary source verification credentialing (PSV) forms the bedrock of vetting competent healthcare professionals.

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.

In rural landscapes, where healthcare resources are already stretched thin, the challenge of credentialing emerges as a significant barrier. This process, essential for maintaining patient safety and operational integrity within medical organizations, becomes an even more formidable obstacle outside urban centers.

This article delves into the complex landscape of telehealth licensing, credentialing, and regulations, offering insights into the dynamics of virtual care provision.