Credentialing is the foundation of payment integrity. Every reimbursement decision depends on accurate provider data, from licensure and enrollment to sanctions screening and credentialing status. When that information is incomplete or outdated, healthcare...
Healthcare payment integrity depends on one thing above all else, and that’s trusted provider data. Health plans use analytics and audits to catch improper payments after the fact; accurate, continuously monitored provider data prevents many of those payments before...
Most claims errors trace back to outdated provider information: expired licenses, inaccurate network status, incomplete credentialing records, missed sanctions and exclusions. Automation alone doesn't catch these. Verified, continuously monitored provider data does,...
Healthcare organizations credential providers three ways: in-house, through a credentials verification organization (CVO), or a hybrid of both. The right choice depends on verification capacity, regulatory requirements, provider data quality, and integration needs,...
Five states advanced healthcare licensing and compliance measures in August 2026. Pennsylvania and Virginia moved to join new interstate licensure compacts, Virginia adopted a program for military-trained medical personnel, and Kentucky, New Jersey, and Oregon...
