Health Plans

For health plans, accurate provider data and comprehensive credentialing are vital for compliance and member satisfaction. Our blog offers valuable insights into provider network management, data integrity, and compliance strategies that drive operational excellence. Learn how automation and real-time data validation optimize provider enrollment and monitoring processes. Stay ahead with the latest best practices and industry advancements.

What Is a PTAN Number and Why Is It Important for Healthcare Providers?

Because Medicare’s expansive system can be susceptible to fraud, it’s critical to identify and authenticate providers and comply with government regulations. Using a combination of PTAN and NPI numbers in their respective places helps healthcare organizations stay in...

How Healthcare Organizations Can Prepare for Upcoming Compliance Audits

If you’re responsible for compliance in your healthcare organization, you probably don’t need a reminder that audits are coming. What you need is a system to stay ready without the last-minute rush. The truth is, successful audits don’t come from neatly stored...

How Healthcare Organizations Can Prepare for Upcoming Compliance Audits

Reducing Payment Integrity Issues in Health Plan Claims Processing

The complexity of the healthcare system and health plan claims processing leaves room for many errors. Unfortunately, such errors can cause operational inefficiencies, increase administrative burden, and indirectly put patients’ health at risk. As such, health plan...

ROI of Outsourced Medical Credentialing

The rapid growth of the healthcare system places a demand on healthcare facilities to onboard more providers to expedite patient care. This translates to long hours spent on provider verification, credentialing, and paperwork, which can sway admin teams. For...

Reducing Payment Integrity Issues in Health Plan Claims Processing

May 15, 2025

The complexity of the healthcare system and health plan claims processing leaves room for many errors. Unfortunately,...

ROI of Outsourced Medical Credentialing

May 15, 2025

The rapid growth of the healthcare system places a demand on healthcare facilities to onboard more providers to...

Understanding Delegated Credentialing

Apr 3, 2025

Imagine a relay race where passing the baton smoothly determines the outcome of the entire event. Now, think of...

The Role of AI in Healthcare Compliance

Mar 6, 2025

Technologies continue to transform the healthcare industry—the da Vinci® Surgical Robot performs precise movements...

Preventing Non-Compliance Consequences in Healthcare

Mar 6, 2025

In the healthcare industry, compliance with regulatory standards is not merely a requirement but a cornerstone of...

What Is Provider Credentialing and Why It Matters in Healthcare

Mar 6, 2025

When a patient walks into a doctor’s office, they want to feel confident that the healthcare professional they’re...

Why Provider Data Quality Matters in Healthcare

Mar 6, 2025

Provider data quality is a fundamental necessity for the healthcare industry. In a high-stakes environment, like a...

Healthcare Credentialing Documents Checklist

Feb 3, 2025

Hiring a new practitioner involves navigating a complex set of requirements for healthcare providers. Each...

What is a Healthcare Compliance Audit?

Jan 8, 2024

Healthcare is a high-risk industry; auditing is the systematic and objective process that mitigates risk. Healthcare...

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Is Your Organization Ready for NCQA’s 2025 Compliance Changes?

Learn more about the updated July 1st NCQA requirements and how Verisys can help maintain your compliant status.

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FACIS® Sanction & Exclusion Screening + Monitoring

Industry’s most accurate and trusted exclusion + sanction dataset.

Healthcare Credentialing

Optimize Cred processes to reduce cost, mitigate risk, and speed up time-to-network.

Decisional Data Verification

OFAC, DEA, Abuse Registry, & more: Confirm your organization makes decisions based on accurate, verified provider data.

Provider Data Management

Transform incomplete, flawed provider data into comprehensive, configurable directories.

Automated Licensure with LicenseCheck

Real-time verification and monitoring of providers’ licenses.

Continuous True Monitoring

Continuously monitor credentials, licenses, and regulatory statuses for real-time confirmation of good standing.

Credential & Certification Verification

Ensure regulatory statuses are always current with real-time alerts.

Pre-Hire & Workforce Compliance

Pre-screen medical credentials, sanctions, and licensure history for real-time workforce compliance.

Comprehensive Coverage

Verisys supports all provider and taxonomy types across all jurisdictions, from surgeons to technicians.

Connect with us →

Is Your Organization Ready for NCQA’s 2025 Compliance Changes?

Learn more about the updated July 1st NCQA requirements and how Verisys can help maintain your compliant status.

Learn More

FACIS® Sanction & Exclusion Screening + Monitoring

Industry’s most accurate and trusted exclusion + sanction dataset.

Healthcare Credentialing

Optimize Cred processes to reduce cost, mitigate risk, and speed up time-to-network.

Credential & Certification Verification

Ensure regulatory statuses are always current with real-time alerts.

Provider Data Management

Transform incomplete, flawed provider data into comprehensive, configurable directories.

Automated Licensure with LicenseCheck

Real-time verification and monitoring of providers’ licenses.

Continuous True Monitoring

Continuously monitor credentials, licenses, and regulatory statuses for real-time confirmation of good standing.

Decisional Data Verification

Confirm your organization makes decisions based on accurate, verified provider data.

Pre-Hire & Workforce Compliance

Pre-screen medical credentials, sanctions, & license history for real-time workforce compliance.

Comprehensive Coverage

Verisys supports all provider and taxonomy types across all jurisdictions, from surgeons to technicians.

Connect With Us

Physician Onboarding Checklist

Hiring a new practitioner is a complex process for many healthcare entities. A physician onboarding checklist can help guide this process by clearly...

What Is Human Capital Management As It Relates To Healthcare?

Human Capital Management (HCM) in the healthcare industry is the strategic approach to recruiting, managing, developing, and retaining healthcare...

Healthcare Exclusion Monitoring – Why It Is So Important to Healthcare Compliance?

Healthcare exclusion monitoring is critical to healthcare compliance because employing or contracting with an excluded provider can result in severe...

How To Strengthen Your Pharmacy Compliance and Reduce Risk

What Is Pharmacy Compliance? In essence, pharmacy compliance is an ongoing commitment to abide by all laws, regulations, and professional standards...

Compliance Resources

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Healthcare compliance insights and news from the industry leader.

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Monthly Compliance Updates

The best resource for monthly healthcare regulatory compliance updates.

Company Announcements

Company news and Verisys updates.

February 2026 Legislative and Compliance Healthcare Updates

This month’s compliance landscape features a major federal fraud enforcement action, a state-level government audit revealing critical data privacy failures, multi-state provider license revocations, and a reminder of the New Jersey Board of Pharmacy’s robust oversi...

Health Plans

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Is Your Organization Ready for NCQA’s 2025 Compliance Changes?

Is Your Organization Ready for NCQA’s 2025 Compliance Changes?

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Monthly Compliance Updates

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February 2026 Legislative and Compliance Healthcare Updates