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.

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...

Understanding Delegated Credentialing

Imagine a relay race where passing the baton smoothly determines the outcome of the entire event. Now, think of credentialing in healthcare as that race—only instead of runners, it's healthcare providers and organizations ensuring qualifications, compliance,...

The Role of AI in Healthcare Compliance

Technologies continue to transform the healthcare industry—the da Vinci® Surgical Robot performs precise movements that enable minimally invasive surgeries, the CyberKnife delivers targeted radiotherapy, and smart devices provide practitioners with instantaneous...

Preventing Non-Compliance Consequences in Healthcare

In the healthcare industry, compliance with regulatory standards is not merely a requirement but a cornerstone of safe, effective, and ethical patient care. When healthcare organizations fail to meet compliance standards, the consequences can be severe—spanning legal...

What Is Provider Credentialing and Why It Matters in Healthcare

When a patient walks into a doctor’s office, they want to feel confident that the healthcare professional they’re seeing is qualified, experienced, and trustworthy. That’s where provider credentialing comes in. Provider credentialing is the formal process by which...

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...

Data Compliance: 3 Focus Areas for Mitigating Organizational Risk

May 10, 2023

There is no question that healthcare organizations should have an effective healthcare compliance program. Despite...

Provider Data Challenges for Health Plans

Mar 7, 2022

By Charlie Falcone While leaving her house to visit her grandson, Sue falls and twists her knee. At the emergency...

Five Ways Payers Can Improve Provider Responsiveness

Jan 4, 2022

By Scott Alsup Consider partnering with a Credentials Verification Organization (CVO) to save time and expedite your...

Data Challenges that Health Plans and Providers Must Navigate

Nov 30, 2021

By: Scott Alsup, Senior Vice President of Operations at Verisys How to Maintain Compliance and Data Integrity Despite...

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

May 26, 2021

Because Medicare’s expansive system can be susceptible to fraud, it’s critical to identify and authenticate providers...

What is Risk Management in Healthcare?

Dec 4, 2020

Patient safety takes first priority in healthcare. To protect patients and reduce the possibility of injury, it is...

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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.

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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.

Learn More

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